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AC Joint Reconstruction

What is AC joint reconstruction?

AC joint reconstruction refers to a surgical procedure performed to treat a severe injury or instability of the acromioclavicular (AC) joint in the shoulder. The AC joint is the joint between the outer end of the collarbone (clavicle) and the acromion, which is part of the shoulder blade (scapula). The stability of the AC joint is maintained mainly by the coracoclavicular (CC) and AC ligaments. When these ligaments are torn or damaged due to trauma or other factors, it can lead to pain, limited shoulder mobility, and instability.

The goal of AC joint reconstruction is to restore the normal alignment and function of the AC joint, relieve pain, and improve shoulder strength and movement.

  1. Severe AC joint dislocation or repeated shoulder separations: When the clavicle is significantly displaced from its normal position due to a complete tear of the ligaments supporting the joint.
  2. Persistent pain and instability: When conservative treatments like rest, physical therapy, and medications fail to alleviate pain and restore joint stability.
  3. Chronic AC joint problems: In some cases, individuals may develop chronic AC joint issues, leading to recurrent dislocations or pain.

Various surgical techniques, including different types of screws, plates, and other fixation devices, can used to in AC joint reconstruction. It often involves using a device to hold the bones in the correct position, allowing the ligaments to heal. The device can be removed at a later date if necessary.  Sometimes a ligament graft, taken from another part of the body or a cadaver is used to reinforce the repair.

Dr. Petrigiano prefers to use the LockDown surgical device to enhance AC joint stability. This involves an implant of a synthetic ligament which studies have shown restores natural motion of the AC joint.

The timing of surgery for acromioclavicular (AC) joint reconstruction is an important factor in the overall success of the procedure.

In the case of acute injuries, immediate surgical intervention may be necessary, especially for severe dislocations or when there is persistent pain, significant deformity, or functional impairment. Early intervention can help reduce the displacement of the joint and reduce pain.

For chronic injuries, which have failed to improve with conservative treatment, surgery can be planned at a more elective pace. However, chronic dislocations can sometimes be more difficult to treat because of scarring, muscle shortening, and other changes that occur over time.

The optimal timing of surgery can also depend on a range of patient-specific factors, including overall health, activity levels, occupation, and patient preferences. For example, an athlete or a manual laborer may opt for a different treatment plan than someone with a sedentary lifestyle or lower functional demands on the shoulder.

As with any surgical procedure, the potential benefits of surgery should be weighed against the potential risks. A detailed discussion with Dr. Frank Petrigliano is essential to making an informed decision about treatment.

In all cases, it’s important to remember that surgery is just one part of treatment and that post-operative care, including physical therapy, is essential to regaining strength and mobility in the shoulder after AC joint reconstruction.

Why choose Dr. Petrigliano?

Los Angeles shoulder surgeon, Dr. Frank Petrigliano is an internationally regarded expert on shoulder injuries, conditions and treatments. Whether you are young or old, athlete or not, suffering from shoulder pain or an injury can be disabling.  Contact Dr. Petrigliano at the Epstein Family Center for Sports Medicine at Keck Medicine at USC. He can help.


  1. Jeong JY, Chun YM. Treatment of acute high-grade acromioclavicular joint dislocation. Clin Shoulder Elb. 2020 Sep 1;23(3):159-165. doi: 10.5397/cise.2020.00150. PMID: 33330252; PMCID: PMC7714286.
  2. https://www.ncbi.nlm.nih.gov/books/NBK493188/
At a Glance

Dr. Frank Petrigliano

  • Associate Professor of Orthopaedic Surgery at USC
  • Chief of the Epstein Family Center for Sports Medicine
  • Team physician for the LA Kings and USC Athletics
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