Acromioclavicular (AC) joint excision is a procedure to remove a small amount of bone from the end of the collarbone where it meets the shoulder blade, relieving pain from arthritis or injury at this joint. It is usually performed arthroscopically.
The procedure is typically performed arthroscopically through small incisions. A few millimetres of bone are removed from the outer end of the collarbone (clavicle) and sometimes from the acromion, creating a small gap that prevents the arthritic bone surfaces from rubbing together. This gap fills with scar tissue over time. The procedure often takes 30–45 minutes and is frequently combined with subacromial decompression.
Surgery is recommended when AC joint arthritis or osteolysis causes persistent pain at the top of the shoulder, typically worsened by reaching across the body or pressing on the joint. It is considered when injections, physiotherapy, and activity modification have not provided lasting relief.
Corticosteroid injection into the AC joint, anti-inflammatory medication, physiotherapy, and activity modification. Injection often provides diagnostic confirmation and temporary relief.
Standard pre-assessment. This is usually a day-case procedure. Plan for limited use of the arm for a few days to weeks.
The aim is to relieve localised AC joint pain. Most patients experience good pain relief, particularly with activities that previously provoked symptoms.
Some discomfort at the AC joint may persist, particularly with heavy loading.
Temporary shoulder stiffness improving with physiotherapy.
If too much bone is removed, the joint may become unstable. This is rare with careful technique.
Approximately 1% risk.
Rare but can occur following any shoulder procedure.
Usually general anaesthesia with a nerve block. Can sometimes be performed under regional anaesthesia alone.
A sling is worn for comfort for a few days. Active movement is encouraged early. Most patients return to normal activities within four to six weeks. Physiotherapy may be recommended to restore full movement and strength. Heavy lifting and overhead work may take six to twelve weeks.
Wound review at two weeks, followed by a consultant review at six weeks.
No. The gap fills with scar tissue and the joint remains stable. The ligaments holding the collarbone in place are preserved.
Most patients return to weight training, though it may take two to three months before heavy pressing movements are comfortable.