AC Joint Reconstruction and Shoulder Separation Repair

AC Joint Reconstruction and Shoulder Separation Repair

What is an AC Joint Separation?

The acromioclavicular (AC) joint is located at the top of the shoulder, where the clavicle (collarbone) connects with the acromion (the roof of the shoulder blade). An AC joint separation, commonly called a shoulder separation, occurs when the ligaments stabilizing this joint are damaged due to trauma or impact.

This injury can occur from direct trauma, such as falling on an outstretched arm, a football tackle, or an automobile accident. The severity of the separation depends on the extent of ligament damage and is graded from mild (Grade 1) to severe (Grade 6).

AC Joint Separation vs. Shoulder Dislocation

A shoulder separation affects the AC joint, whereas a shoulder dislocation occurs when the upper arm bone (humerus) moves out of its socket in the glenohumeral joint. Shoulder dislocations involve different ligaments and require distinct treatment approaches.

Symptoms of AC Joint Separation

  • Visible bump or deformity at the top of the shoulder
  • Pain and tenderness at the AC joint
  • Swelling and bruising
  • Difficulty lifting the arm or carrying weight
  • Weakness in the shoulder and arm

When is AC Joint Reconstruction Necessary?

Lower-grade separations (Grade 1-3) may heal with non-surgical treatments such as rest, ice, and physical therapy. However, severe injuries (Grade 4-6) often require surgical AC joint reconstruction to restore stability and function.

Reconstruction is typically needed for athletes, laborers, or individuals experiencing persistent pain, muscle fatigue, or instability due to a chronic AC joint injury.

How is AC Joint Reconstruction Performed?

The procedure involves reconstructing the coracoclavicular (CC) ligaments using a tendon graft (either from the patient or a donor). This graft is looped between the coracoid process and the clavicle, restoring the normal alignment of the AC joint.

Strong sutures and specialized fixation devices secure the reconstruction, ensuring stability during healing. The surgery is often performed using minimally invasive techniques, allowing for faster recovery.

Recovery After AC Joint Reconstruction

Patients typically wear a sling for several weeks to protect the repair. Physical therapy is introduced gradually to restore range of motion and strength. Full return to sports and strenuous activity usually occurs within 4-6 months.