Acromioclavicular (AC) Joint Reconstruction


Acromioclavicular (AC) joint reconstruction is a surgical procedure intended to rebuild the AC joint which is situated at the top of the shoulder between the acromion of the scapula and the clavicle. This joint can be injured by trauma like a fall on the shoulder which leads to AC joint dislocation or separation.


AC joint reconstruction is typically indicated for:AC joint reconstruction is typically indicated for:

·        Recurrent or persistent acute acromioclavicular joint dislocations or separations (especially Grade III and above).

·        Failure to respond to conservative measures such as rest, physiotherapy, and analgesics.

·        Athletes or physically active individuals with persistent instability or pain.

There are different kinds of AC joint injuries.

AC joint injuries are classified into six grades based on the severity of the dislocation:AC joint injuries are classified into six grades based on the severity of the dislocation:

·        Grade I: Simple fracture with no fixation.

·        Grade II: Incomplete dislocation with some degree of movement.

·        Grade III: A complete dislocation with a discernible bump.

·        Grades IV-VI: Comminuted dislocations with other associated injuries and significant bone deformity.

Surgical Techniques

Several surgical techniques are used for AC joint reconstruction, including:Several surgical techniques are used for AC joint reconstruction, including:

1.     Open Reduction and Internal Fixation (ORIF):Open Reduction and Internal Fixation (ORIF):

·        Involves cutting into the joint to realign it and then using hardware like plates, screws, or wires to secure it.

2.     Allograft Reconstruction:

·        It employs donor tissue (allograft) to reconstruct the damaged ligaments and offer support.

3.     Autograft Reconstruction:

·        Replaces the damaged ligaments with the patient’s own tissue (autograft), for instance, a tendon from the hamstring.

4.     Arthroscopic Techniques:

·        Endoscopic technique that involves making small cuts on the body and using a camera to perform the repair and reconstruction.

5.     Weaver-Dunn Procedure:

·        A frequent method that involves moving the coracoacromial ligament to the clavicle in order to gain stability.

6.     Hook Plate Fixation:

·        A hook plate is used to fix the distal clavicle to the acromion until the fracture union is achieved.


Postoperative rehabilitation is crucial for successful outcomes and typically involves:Postoperative rehabilitation is crucial for successful outcomes and typically involves:

·        Immobilization: A sling or brace for a few weeks to allow for the initial healing process to take place.

·        Physical Therapy: Slow progressive mobility and strengthening exercises for the affected part.

·        Activity Modification: Not to engage in activities that involve heavy lifting and contact sports until the wound has completely healed.


The results of AC joint reconstruction are usually satisfactory with most of the patients reporting reduction in pain and improvement in shoulder mobility. The outcomes of the surgery depend on the type of injury, the surgical method applied, and the postoperative physical therapy regimen.

Risks and Complications

Potential risks and complications include:Potential risks and complications include:

·        Infection.

·        Hardware problems or difficulties.

·        Chronic pain or discomfort.

·        Loss of motion.

·        Revision surgery indication.


AC joint reconstruction is a viable surgical procedure for patients with chronic instability or severe AC joint injuries that have failed to improve with non-operative management. New developments in surgical approaches and physiotherapy enhance the results of patients who have undergone this procedure.