AC Reconstruction
AC Reconstruction in San Antonio, TX
A fall onto your shoulder, a collision in football or hockey, or a bike crash can tear the ligaments that hold your collarbone to your shoulder blade. When these ligaments are torn, your collarbone may sit higher than normal, and your shoulder can feel painful, weak or unstable. If your injury is severe or has not settled with nonsurgical care, AC reconstruction may be part of your treatment.
Travis C. Burns, MD, a board-certified orthopedic surgeon in San Antonio, TX, evaluates shoulder injuries at his Medical Center, Alamo Heights and Westover Hills offices. Dr. Burns specializes in arthroscopic and open shoulder procedures, including open reconstruction for some shoulder separations, and he considers your injury, activity level and goals when discussing whether reconstruction is right for you.
What Is AC Reconstruction?
AC reconstruction is surgery that restores stability to the acromioclavicular (AC) joint by rebuilding the torn ligaments that hold your collarbone in place. The AC joint is where your collarbone meets the acromion, a part of your shoulder blade. Strong ligaments, including the coracoclavicular (CC) ligaments, keep this joint stable. In a significant AC separation, these ligaments tear and your collarbone is no longer held in position.
Reconstruction typically uses a tendon graft to rebuild the ligaments and secures your collarbone in a more normal position. It differs from treatment for arthritis or wear of the joint described on the AC Joint Injury page, which often involves trimming the end of the collarbone.
What Are the Benefits of AC Reconstruction?
If you are an appropriate candidate, reconstruction may offer potential benefits:
- Restored stability: Rebuilt ligaments may help hold your collarbone in position.
- Less pain: Stabilizing the joint may ease pain when you lift or reach overhead.
- Improved function: Better support may help your strength and endurance in daily tasks.
- Appearance: The prominent bump may be reduced, although some prominence may remain.
- Return to activity: Many patients work toward getting back to sports and work.
Your benefits depend on your health, the severity of your injury and your rehabilitation plan.
Who Needs AC Reconstruction?
You may be a candidate for AC reconstruction if imaging and examination show a significant AC injury. Situations may include:
- A high-grade AC separation in which your collarbone is clearly displaced
- Persistent pain or weakness after nonsurgical treatment
- Instability that limits your work, sport or overhead activity
- A physically demanding job or a throwing or contact sport
- A chronic AC injury that continues to cause symptoms
- Associated shoulder injuries that need to be addressed
Not every AC injury requires surgery. Lower-grade injuries often improve with a sling, rest and therapy. Dr. Burns can evaluate your shoulder and discuss which approach fits you.
What Does Preparation for AC Reconstruction Involve?
Your evaluation includes an exam and X-rays, and sometimes stress views or MRI to assess the ligaments and other shoulder structures. You and your surgeon will discuss timing, graft choices and what to expect. Your care team will also review your medications and the day of surgery, as described in the Preoperative Instructions.
Planning ahead for a sling and for help with daily tasks may make your recovery easier.
How Is AC Reconstruction Performed?
After you receive anesthesia, an incision is made over the top of your shoulder. Your collarbone is brought back into its normal position, and a tendon graft, either from your own body or from a donor, is used to rebuild the torn ligaments. The graft is secured around or through the bone, and fixation devices may be used to hold the position while healing occurs.
In some cases, arthroscopic assistance allows your surgeon to look inside the shoulder and treat other injuries at the same time, as described on the Shoulder Arthroscopy page. The exact technique depends on your injury and is discussed with you before surgery.
The incisions are then closed, and a dressing and sling are applied.
What to Expect During Recovery After AC Reconstruction?
The First Weeks
You will typically wear a sling for a period to protect the reconstruction. Soreness and swelling are common, and pain medication is typically provided. You may be encouraged to move your elbow, wrist and hand.
The Following Months
Physical therapy progresses from gentle motion to strengthening in stages. Lifting, push-ups and overhead activity are often limited until the reconstruction has healed. See the Postoperative Instructions and Physical Therapy Protocols pages.
Returning to Activity
Return to sports and heavy work generally takes several months and varies by patient. Contact and collision sports may require longer.
What Are the Risks and Complications of AC Reconstruction?
As with any surgery, there are potential risks. Possible risks and complications include:
- Infection
- Stiffness or loss of shoulder motion
- Loosening or failure of the graft or fixation
- Recurrence of the collarbone displacement
- Fracture of the collarbone or shoulder blade
- Nerve or blood vessel injury
- Hardware irritation
- Persistent pain or a remaining bump
Your surgeon can discuss these risks and how they apply to you based on your individual condition, health and activity goals.
Why Choose Dr. Burns for AC Reconstruction in San Antonio, TX?
Travis C. Burns, MD is a board-certified orthopedic surgeon with subspecialty fellowship training in orthopedic sports medicine through the John A. Feagin, Jr. Sports Medicine Fellowship. His practice centers on arthroscopic surgery of the shoulder, hip and knee, which is directly relevant to AC joint injuries. He performs both arthroscopic and open shoulder procedures, so your treatment plan can be matched to your injury.
Dr. Burns previously served as Chief of Sports Medicine at San Antonio Military Medical Center, where his clinical focus was complex shoulder, hip and knee injuries. He has been active in research and academic medicine, including more than 35 peer-reviewed publications. You can meet with him at the Medical Center, Alamo Heights or Westover Hills office, depending on what is most convenient for you.
AC Reconstruction FAQs
What is AC reconstruction?
AC reconstruction is surgery that rebuilds the torn ligaments between your collarbone and shoulder blade, usually with a tendon graft, so your collarbone is held back in a more normal position.
Does every AC separation need surgery?
No. Many lower-grade AC separations heal with a sling, rest and therapy. Surgery is usually considered for higher-grade injuries or for symptoms that do not improve.
Will the bump on my shoulder go away?
Reconstruction may reduce the bump, but some prominence may remain. Your surgeon can describe what is realistic for your injury.
What graft is used for AC reconstruction?
The graft is tendon taken either from your own body or from a donor. The choice depends on your injury and your surgeon's recommendation.
How long will I be in a sling?
Sling use varies by patient and technique and often lasts several weeks. You will receive specific instructions after surgery.
When can I lift or play sports after AC reconstruction?
Lifting and sports are reintroduced in stages once healing and strength allow. This typically takes several months and varies from person to person.
AC Reconstruction in San Antonio, TX
If a shoulder injury has left your collarbone out of place or your shoulder feels unstable, an evaluation can clarify your options. Request an appointment in San Antonio with Dr. Burns at the Medical Center, Alamo Heights or Westover Hills office to discuss your AC reconstruction options. You can call (210) 705-5060 to schedule a visit.
