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ACJ reconstruction

What is ACJ reconstruction?

Acromioclavicular joint (ACJ) reconstruction surgery may be offered to you if you have damaged your ACJ (where your collarbone joins your shoulder blade) as the result of a fall or collision.

Surgery is normally only offered in the case of severe damage. For less serious damage, other less invasive techniques are recommended. ACJ reconstruction is a commonly performed procedure with good long-term results.

What does ACJ reconstruction surgery involve?

During an operation, your consultant will stabilise your damaged ACJ either by using sections of your own ligament taken from the front of your shoulder (the coracoacromial ligament) or by using an artificial ligament, which is looped around your clavicle (collarbone) and the coracoid process from the shoulder blade. This will pull your separated shoulder back into place, helping to stabilise the ACJ and reducing pain. In severe cases a temporary plate may also be required whilst the ligaments have a chance to heal. This may need to be removed as a second operation.

An ACJ ligament repair is carried out under general anaesthetic. The replacement ligament is inserted through an incision in the top and front of the shoulder and secured to the clavicle with a screw. The procedure will leave you with a scar of 5-7cm running along the top of your shoulder.

Afterwards, your arm will need to be supported in a sling for at least three weeks – otherwise the weight of your arm could pull the repair apart. If your surgeon uses your own ligament to repair the ACJ you will need to wear the sling for a minimum of four weeks.

Immediately after surgery you will be given an X-ray to check on the repair and shown a series of exercises to regain the movement and strength of your shoulder by the physiotherapist.

ACJ reconstruction

Shoulder and elbow consultants

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