ACJ excision arthroplasty

This procedure is often performed in conjunction arthroscopic subacromial decompression. It is performed when the joint is tender clinically

The Operation

The operation is done by ‘keyhole surgery’; usually through two or three 5mm puncture wounds. The operation involves shaving about 5mm from the inner part of the acromion and the tip of the clavicle (collar bone).

General Advice

You will usually be in hospital either for a day or overnight. The operation is performed under general anaesthetic and a nerve block in your neck or upper chest that will make your arm numb for 8-12 hours after surgery. This is for post-operative pain relief. After this the shoulder may well be sore and you will be given painkillers to help this. Ice packs may also help reduce pain.

You will return from theatre wearing a sling. This will be for your comfort only but you will be allowed to move your arm. Most patients, however, keep the sling on for 10-14 days.

A doctor/physiotherapist will see you prior to discharge and you will be taught exercises to do and given further advice to guide you through your recovery.


As with all surgery there is a risk of some complications. These are rare, but you should be aware of them before your operation. They include:

  • Complications relating to the anaesthetic.
  • Infection.
  • Injury to the nerves or blood vessels around the shoulder.
  • Prolonged stiffness and or pain.
  • Failure to achieve successful result.
  • A need to redo the surgery.

What to expect afterwards


A nerve block is usually used during the surgery. This means that immediately after the operation the shoulder and arm often feel completely numb. This may last for a few hours. After this the shoulder may well be sore and you will be given painkillers to help this whilst in hospital. These can be continued after you are discharged home. Ice packs may also help reduce pain. Wrap crushed ice or frozen peas in a damp, cold cloth and place on the shoulder for up to 15 minutes.

Wearing a sling

You will return from theatre wearing a sling. The surgeon/physiotherapist will advise you on how long you are to continue wearing the sling. 

The Wound

This keyhole operation is usually done through three 5mm puncture wounds. There may be stitches or small sticking plaster strips over the wounds. These should be kept dry until healed. This usually takes 10 to 14 days.


You will not be able to drive for the first 10-14 days. 

Returning to work

This will depend on your occupation. You will need to discuss this with your surgeon.

Leisure Activities

Your physiotherapist and surgeon will advise you when it is safe to resume your leisure activities.

Follow up Appointments

An appointment will be made for you to be reviewed at 2 weeks.


You may well be expected to perform the following exercises when you leave hospital. Please check with your physiotherapist before commencing.