Shoulder (ACJ) Separation Surgery

There are several surgical options available to treat Acromioclavicular Joint (ACJ) Separation, with the choice largely contingent on the severity of the injury as well as the patient’s physical condition and lifestyle requirements.

  1. Open Reduction and Internal Fixation (ORIF): This procedure involves realigning the separated joint and using surgical hardware like screws or plates to hold it in place. The surgeon makes an incision over the AC joint, repositions it, and secures it with the hardware.
  2. Arthroscopic Repair: Unlike ORIF, this is a less invasive procedure. Using a tiny camera (arthroscope) and miniature surgical tools, the surgeon repairs the injured AC joint through small incisions.
  3. Coracoclavicular Ligament Reconstruction: In this procedure, the surgeon uses a graft (usually taken from the patient’s own body or a donor) to replace the damaged coracoclavicular ligaments, thereby stabilising the AC joint.

Expected Surgery Outcome

The primary goal of any ACJ separation surgery is to restore stability to the shoulder, relieve pain, and regain full range of motion. Most patients can expect to resume normal activities within 3 to 6 months following the surgery. However, the timeline can vary based on the severity of the initial injury and the individual’s overall health.

Potential surgery complications and risks

As with any surgical procedure, ACJ separation surgery carries potential risks like infection, nerve or blood vessel damage, and complications from anaesthesia. There’s also the possibility of developing arthritis in the AC joint over time.


  • Infection: There’s always a risk of infection with any surgery. If infection occurs, it might require additional treatment with antibiotics.
  • Nerve or Blood Vessel Damage: These structures could be accidentally injured during the surgery, leading to temporary or permanent problems.
  • Complications from Anaesthesia: This could include allergic reactions or respiratory problems.
  • Hardware Irritation: In some cases, the surgical hardware may cause discomfort or skin irritation. Occasionally, a second procedure might be necessary to remove the hardware.
  • Joint Arthritis: Over time, patients may develop arthritis in the treated AC joint, which might result in discomfort and limited range of motion.

Recovery after surgery

Following ACJ separation surgery, the arm is typically immobilised with a sling for the first few weeks to allow the joint to heal. Pain management strategies are implemented immediately, and physiotherapy commences as soon as the surgeon deems appropriate, usually within a few weeks. The recovery timeline varies greatly depending on the surgery type and the patient’s overall health, but typically ranges from 3 to 6 months.