AC Joint Surgery (Distal Clavicle Excision)
Distal clavicle excision and other AC joint procedures with Dr. Steven Ward in Tucson and Oro Valley — for arthritis or lasting pain where the collarbone meets the top of the shoulder.
Call 520-881-1394Typical ranges for general education. Dr. Ward’s plan for you may differ.
What it treats
The acromioclavicular (AC) joint is where the end of the collarbone (clavicle) meets the top of the shoulder blade (acromion). Problems here cause pain on the top of the shoulder.
- AC joint arthritis — wear of the cartilage in the joint; common on X-rays and not always painful, but it can cause pain with reaching across the body, overhead work, or lying on that side
- Arthritis after an injury, such as a previous shoulder separation
- Painful shoulder separation — an AC joint sprain from a fall onto the shoulder; most heal well without surgery, even with a visible bump
Is surgery right for you?
Treatment starts without surgery:
- Changing activities that provoke pain, such as heavy pressing or reaching across the body
- Ice and anti-inflammatory medication when it is safe for you
- Physical therapy
- An injection into the AC joint, which can relieve pain and also help confirm the AC joint is the source
Surgery is considered when pain persists and limits you despite that care. For shoulder separations, surgery is reserved for ongoing pain or a severe deformity.
How the surgery is done
A distal clavicle excision removes a small amount of bone from the worn end of the collarbone so the bones no longer rub. The small gap fills in with scar tissue over time, and the ligaments that hold the collarbone steady are preserved.
It can be done arthroscopically, often together with a subacromial decompression, or through a small open incision on top of the shoulder. Most patients go home the same day.
For a severe or persistently painful shoulder separation, a different operation reconstructs the ligaments under the collarbone. That surgery has a longer, more protected recovery, and Dr. Ward will review it with you if it applies.
Often done with other procedures
AC joint arthritis frequently travels with impingement or rotator cuff problems. If you also have a rotator cuff repair, your sling time and rehab follow that plan instead — see rotator cuff repair.
Recovery overview
Typical ranges after an isolated distal clavicle excision. Dr. Ward’s plan for you may differ, and ligament reconstruction takes longer.
Weeks 0–2
- Sling for a short time for comfort
- Gentle shoulder motion begins early, along with hand, wrist, and elbow movement
- Ice and scheduled pain control as directed
Weeks 2–6
- Work toward full range of motion, at home or with a therapist
- Return to light daily activities
- Avoid heavy lifting, pushing, and reaching across the body
Weeks 6–12 and beyond
- Progressive strengthening
- Heavier lifting, pressing exercises, overhead work, and sports return gradually as comfort and strength allow
- Some tenderness on top of the shoulder can take a few months to settle fully
When to call the clinic
Call 520-881-1394 if you notice any of the following after surgery or while you are recovering:
- A fever of 101°F or higher, or chills
- Redness spreading around an incision, or drainage that is cloudy, foul-smelling, or keeps soaking the dressing after the first few days
- New or worsening numbness, tingling, or weakness in the arm or hand once the nerve block has worn off, or fingers that turn pale, blue, or cold
- Pain that is not controlled by your prescribed medication, ice, rest, and the sling
- Swelling, pain, or tenderness in the calf or arm that is new or getting worse
It is normal for the shoulder and arm to feel numb for roughly 12–24 hours after a nerve block, and for the shoulder to be sore and bruised for a while. Call if something feels different from what you were told to expect.
for chest pain, shortness of breath, or trouble breathing. These can be signs of a blood clot in the lungs and need emergency care.
If something does not match the instructions you were given, call the office. Dr. Ward or one of his physician assistants will get back to you.
Related resources
Shoulder arthroscopy post-op
Wound care, pain control, ice, and early motion after arthroscopic shoulder surgery.
Open pageShoulder post-op hub
All of Dr. Ward’s shoulder packets, rehab protocols, and anatomy guides in one place.
Open pageExercise guides
Printable home exercise programs to use with your physical therapist.
Open pageRotator cuff repair
What happens when a torn rotator cuff tendon is repaired, and the week-by-week rehab plan.
Open pageOrthoInfo: Arthritis of the shoulder
Includes AC joint arthritis and distal clavicle excision, from the AAOS.
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