Acromioclavicular Joint Stabilisation
How is Acromioclavicular Joint Stabilization Performed?
Acromioclavicular (AC) joint stabilization is performed to restore alignment and stability of the collarbone (clavicle) to the acromion (scapula) after a dislocation or ligament injury. The procedure can be done arthroscopically or through an open incision. Torn coracoclavicular ligaments are reconstructed using sutures, buttons, anchors, or synthetic grafts to secure the clavicle back into position. In some cases, a tendon graft is used to reinforce the repair. In certain situations, a “hook plate” may be used to stabilize the AC joint; however, this must be removed later to prevent significant erosion or fracture of the acromion. The goal of surgery is to restore shoulder strength, stability, and motion while preventing chronic pain or deformity.
What Is the Recovery in the Immediate Postoperative Period?
Hospital stay: Most patients stay 1–2 days in hospital to recover and begin physiotherapy.
Sling: You will wear a sling to support and protect the shoulder for approximately 6 weeks.
Range of motion: Gentle active/passive motion begins under physiotherapist supervision after 2–3 weeks, with range-of-motion restrictions. Full active movement and strengthening are gradually introduced at around 6–8 weeks.
Ice: Used frequently to control pain and swelling. You should ice for 20 minutes, 3–4 times per day immediately after surgery. An ice/compression machine can be hired from a third party.
Sleep: You may find it more comfortable to sleep in a reclined or semi-upright position with the sling on for the first few weeks.
How Is the Wound Managed?
Bulky dressings will be removed 1–2 days after surgery.
A waterproof underlay dressing should be left on for 2 weeks.
Incisions typically heal within 2 weeks.
Showers are permitted while wounds are covered with waterproof dressings during the first 2 weeks.
Do not submerge incisions in water (baths, pools, or ocean) for 6 weeks.
A wound check with your GP, allied health provider, or our clinic is recommended at 2 weeks.
Absorbable sutures are usually used and do not require removal, though small remnants may surface naturally during healing.
How Do I Manage My Pain After an Acromioclavicular Joint Stabilization Procedure?
Your anaesthetist may use a regional nerve block to help control pain immediately after surgery.
Local anaesthetic will also be injected into the shoulder during the procedure.
Use ice regularly (20 minutes, 3–4 times per day). An ice machine may be hired from a third party.
Take prescribed pain medication as directed. Opioids may be used short-term but have known side effects (nausea, constipation, dependence). Non-opioid medications such as paracetamol or anti-inflammatories are preferred when tolerated.
Keep the arm supported in the sling to reduce strain on the repair and minimise pain.
What Issues Should I Call the Clinic Regarding?
You should contact your surgeon or clinic immediately if you notice:
Increasing redness, swelling, or drainage from the wound.
Persistent or worsening pain not controlled by medication.
Fever, chills, or night sweats.
Numbness, tingling, or weakness that does not improve after the nerve block wears off.
Any sudden injury or fall resulting in pain or deformity at the shoulder.
Prompt review allows early management of potential complications.
When Can I Return to Normal Activities After Acromioclavicular Joint Stabilization?
Recovery varies depending on the extent of injury and surgical repair. As a general guide:
Light daily activities: Immediately, using your non-operated arm.
Desk or computer work: 2–3 weeks, if comfortable.
Shoulder movement: Gentle motion usually begins around 2–3 weeks, with active strengthening at 6–12 weeks.
Contact or overhead sports: Typically, not recommended before 6 months post-surgery, depending on progress.
When Can I Drive?
You can usually drive once you can safely control the steering wheel and perform emergency manoeuvres comfortably. This is typically around 6–8 weeks after surgery. You must not drive while taking strong pain medication (e.g., opioids).
When Can I Return to Work?
Return to work depends on your occupation:
Office or sedentary work: 2–3 weeks, once you can commute safely.
Light manual work: 6–10 weeks.
Heavy manual labour or overhead work: 3–4 months or longer, depending on recovery and shoulder stability.
Should I See a Physiotherapist?
Physiotherapy is recommended for optimal recovery after AC joint stabilization. Your physiotherapist will:
Guide you through a structured rehabilitation program focusing on range of motion, scapular stability, and progressive strengthening.
Emphasize posture, shoulder mechanics, and safe progression to higher-level activity.
Most patients continue physiotherapy for 4–6 months to achieve full functional recovery.
What Are the Complications After an Acromioclavicular Joint Stabilization Procedure?
While uncommon, potential complications include:
Recurrent instability or displacement of the clavicle.
Shoulder stiffness or loss of motion.
Decreased shoulder function.
Increased pain or discomfort.
Inability to return to the same level of work or sport.
Infection or wound healing problems.
Nerve irritation (axillary or musculocutaneous) or numbness around the incision.
Hardware irritation or failure of fixation devices.
Persistent pain or deformity at the AC joint.
Fracture around fixation points (acromion, clavicle, or coracoid process).
Arthritis in the acromioclavicular joint.
Complications related to the anaesthetic block (temporary nerve effects, shortness of breath, or rarely pneumothorax).
