The acromioclavicular (AC) joint is located at the top of the shoulder between the clavicle (collarbone) and acromion (part of the shoulder blade that forms the hard, bony region on the top of the shoulder). Severe damage to the acromioclavicular and coracoclavicular (CC) ligaments in the AC joint can lead to high grade (grade IV-VI) separations and cause an extreme dislocation of the clavicle from the acromion. The ruptured ligaments of the AC joint and dislocated clavicle can disrupt shoulder muscles and tendons and cause severe pain. High grade AC joint separations often require surgical repair. AC joint repair/reconstruction can be performed arthroscopically or with a traditional open procedure depending on the separation. For a less severe dislocated clavicle, arthroscopic instruments will be used to remove the end of the clavicle and realign it back in its normal position to alleviate pain in the joint. A variety of techniques are available to stabilize the AC joint during a repair.  For more severe dislocations, or for chronic dislocations, an allograft or autograft of tendon reconstruction is used to replace the torn AC and CC ligaments. First, the clavicle is realigned and then two tunnels are created in the bone. The graft is attached to specialized screws that are then inserted securely into the clavicle. The graft wraps tightly around the coracoid (a bony process in the shoulder) and now serves as a replacement for the original ligaments that helps restore the biomechanical properties of the joint. Patients are required to wear a sling to immobilize the affected shoulder after surgery for 6-8 weeks. Following a specific therapy plan of active and assisted stretching of the shoulder will improve recovery and mobility of the shoulder. After approximately 6 months, athletes are able to return to contact sports.