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The acromioclavicular(AC) joint is where two bones in your shoulder meet - these are your collarbone (clavicle) and part of your shoulder bone called the acromion. Your AC joint is important because it allows you to move your shoulder fully.
AC joint injuries are common, particularly in people in their twenties, and are usually due to injury or trauma. They are more common in men than women and are often caused by falling onto an outstretched arm, an injury during contact sports like rugby, or cycling and car accidents.
Mild cases can often be treated without surgery, but if your injury is severe, surgery may be needed to repair and stabilise your joint.
Call 0141 300 5009 or book online today to arrange a consultation to discuss private AC joint surgery with a consultant of your choice at Circle Health Group.
This page explains what AC joint surgery is, when you may need it, what happens during the surgery and what to expect afterwards.
The most common conditions that affect the AC joint are:
Osteoarthritis
This is damage to the cartilage due to wear and tear on your joints. This causes pain and swelling in the affected joint. Osteoarthritis in the AC joint is common in weightlifters.
AC joint separation
This occurs when the ligaments of your AC joint become torn, and your collarbone is not in line with the acromion. AC separation injuries are graded from mild to severe depending on which ligaments are torn and how severely. These are:
- Mild (grade 1) - there is no damage to your ligaments and only your joint itself is injured
- Moderate (grade 2) - there is damage to your ligaments at your AC joint and your ligaments that attach your collarbone to part of your shoulder blade. Your collarbone may not line up with the acromion creating a visible bump at the AC joint
- Severe (grade 3) - Your coracoclavicular ligaments are completely torn and the collarbone and shoulder blade are separated resulting in your AC joint becoming deformed
Fractures
A broken collarbone is a common sports injury, particularly in cycling and off-road motorcycling.
Symptoms of an injury to your AC joint may include:
- Pain
- Swelling
- Bruising
- Weakness in your upper arm or shoulder
- A bump at the top of your shoulder caused by your collarbone moving out of position
At your first consultation, you will be seen by a consultant orthopaedic surgeon, a doctor specialising in problems with the bones and joints.
Your consultant will ask you about your symptoms and medical history including any recent injury to your shoulder. They will perform a physical examination of your shoulder to check for tenderness, swelling, bruising and deformity. They will order scans of your shoulder which may include an X-ray, ultrasound, or MRI.
How is a diagnosis made?
A diagnosis of AC joint injury is made using a combination of:
- Your symptoms
- Medical history
- Physical examination
- The results of any tests and scans
Why is this first consultation so important?
At Circle Health Group, your first appointment is very important as it's where your consultant will ask you about your symptoms, perform a physical examination, order any necessary tests, provide a diagnosis, and discuss possible treatments.
Your first consultation is also where we get to know you and discuss your expectations for treatment. It is important to us that you are as well-informed and comfortable as possible before, during, and after your treatment, so we encourage you to ask as many questions as possible.
After making a diagnosis, your consultant will assess the severity of your AC joint injury and determine the best course of treatment for you.
Most types of AC joint injury resolve without surgery within two to three months of nonsurgical treatment.
Nonsurgical treatments include:
- Immobilising your shoulder in a sling
- Applying ice packs to reduce swelling
- Non-steroidal anti-inflammatory drugs like ibuprofen or naproxen to relieve pain and reduce inflammation
- Physiotherapy to build strength and stabilise the shoulder joint
If your injury is severe or has not healed after a couple of months of nonsurgical treatments, your consultant may recommend surgery called AC joint repair surgery. This procedure aims to restore movement and stability and reduce pain by reconstructing your ligaments and removing the end of the damaged clavicle.
Your consultant will tell you everything you need to do to prepare for your surgery. If there's anything you're not sure about, or if you have any questions about how to prepare for your surgery, speak to your consultant.
It's important to be as healthy as possible before your operation by following a healthy diet, taking regular exercise, not smoking, and drinking alcohol within safe limits. Being in optimal health before your surgery can help reduce the risk of complications and speed up your recovery.
You will have your arm in a sling for four to six weeks after your surgery and will need help with household tasks like cooking and cleaning. Try to arrange for someone to stay with you for at least the first few days after your surgery.
Before your surgery, tell your consultant about any medical conditions or allergies you have, as well as any medication, including over-the-counter medicines you are taking.
Your consultant may tell you to stop taking medications such as blood thinners like aspirin and warfarin before your operation. This is to reduce the risk of bleeding during and after your surgery.
You will not be able to eat or drink anything from midnight on the day of your operation.
AC joint repair surgery may be performed arthroscopically (keyhole surgery), or as open surgery depending on the severity of your injury and when it occurred.
You will be given a general anaesthetic and regional nerve block for your surgery which means you will be asleep for the procedure and won't feel any pain.
AC joint repair surgery can be performed in several different ways including:
- Repositioning and repairing your joint and stabilising it with pins
- Stabilising your collarbone with sutures, screws, or metal implants
- Reconstructing your damaged ligaments by repairing or replacing them with your own, or donor tissue
AC joint repair surgery normally takes between one and two hours.
After your surgery, you will have a bulky dressing in place over your surgery site. This can normally be removed after three days.
You will also have a waterproof dressing that should stay on until you have your sutures removed after around twelve days.
You will need to keep your arm in a sling for four weeks after arthroscopic surgery and six weeks after open surgery.
Recovery from surgery is different for everyone and depends on many factors including your age, general health, the type of surgery you had and your individual progress. Talk to your consultant about what you can expect after your surgery.
How many nights will I need to stay in hospital?
AC joint surgery may be done as a day case meaning you'll go home the same day, or you may need to stay one night in hospital.
Will I be able to drive home?
You will not be able to drive yourself home after your operation. Make arrangements for someone to collect you, or we can organise a taxi if you prefer.
How soon can I go back to work?
How soon you can go back to work depends on the type of procedure you had, your recovery, and the type of job you do. In general, you can return to office work (wearing a sling and with no lifting) after between two and four weeks, light physical work after around twelve weeks and strenuous, physical work after between sixteen and twenty-four weeks.
How soon can I drive?
It is normally around six weeks before you can drive.
When will I be back to normal?
When you will be back to normal after your surgery depends on the type of procedure you had, your age, general health and whether there were any complications during or after your surgery.
Recovery is a gradual process and it's important that you follow your consultant's instructions carefully and go at your own pace when recovering from surgery. Trying to do too much too quickly can result in complications and may delay your recovery. Most people recover fully from AC joint surgery in between six and twelve weeks.
Your consultant will arrange a follow-up appointment with you around two weeks after your surgery to check your progress. Talk to your consultant about when you can expect to be back to normal after your surgery.
As with all types of surgery, AC joint repair surgery carries a small risk of complications. Your consultant will explain all the possible risks and complications before your surgery and answer any questions you may have about your procedure. Being as well-informed as possible about what to expect from your surgery will help put your mind at rest and allow you to make an informed decision, so please ask any questions you may have.
General risks of surgery include:
- Bleeding
- Infection
- Blood clots
- Adverse reactions to the anaesthetic
- Nerve damage
Possible complications specific to AC joint repair surgery include:
- Joint stiffness (this usually settles over time, but in some cases may require further surgery)
- Instability of the AC joint
- Coracoid/clavicle fracture or erosion (rarely, your coracoid or clavicle bones may erode or fracture during or after surgery)
- Numbness of your surgical scar
- The surgery may be ineffective
We answer some of your most commonly asked questions about AC joint surgery.
Is AC joint surgery worth it?
Whether AC joint surgery is worth it depends on the severity of your injury and your expectations for surgery. Most AC injuries can be treated without surgery, but in cases where surgery is recommended, the outcome is usually excellent. Talk to your consultant about whether AC joint surgery is a good option for you.
How long does AC joint surgery take to heal?
Recovery from AC joint surgery varies from patient to patient but usually takes between six and twelve weeks.
How long does AC joint surgery take?
AC joint surgery normally takes between one and two hours.
How painful is AC joint surgery?
During your surgery, you will have a general anaesthetic and regional nerve block, which means you will be asleep for your operation and have no pain. After your surgery, it's normal to experience some post-operative pain for a few days. Your consultant will prescribe painkillers for this. Most patients experience significant pain relief after their recovery from AC joint surgery and can return to sports and activities they enjoyed before their initial injury.
Can I sleep on my side after AC joint surgery?
Sleeping on your affected side can delay healing and cause further injury to your shoulder. The best sleeping position for the first six weeks after surgery is a semi-upright position. You can either prop yourself up with pillows or sleep in a reclining chair. Keep your arm in a sling at night and put a pillow under your arm and elbow for support.
If you sleep on your unaffected side, make sure there are plenty of pillows behind you to prevent you from rolling onto your affected side.
At Circle Health Group we have the experience and expertise to ensure the best possible care and outcome for our patients. As a patient with Circle Health Group you can expect the highest standards of care including:
- Flexible appointment times and locations that are convenient for you
- The freedom to choose which hospital and consultant best suit your needs
- Personalised, consultant-led treatment plans tailored to your individual needs
- Comfortable and safe private facilities maintained by expert multidisciplinary teams
- Private ensuite rooms as standard
- A range of delicious healthy meals
- Affordable, fixed-price packages with aftercare included
- Flexible payment options to help you spread the cost of your care
If you would like to see a consultant or learn more about AC joint surgery, book your appointment online today or call a member of our team directly on 0141 300 5009.
Content reviewed by Circle in-house team in January 2023. Next review due January 2026.
- AC Joint Problems, John Hopkins Medicine
- The surgical treatment of acromioclavicular joint injuries, PubMed
- Separated Shoulder, Cleveland Clinic
- Acromioclavicular Joint Problems, Patient Info
