Injuries from sporting activities account for 25–50% of all acromioclavicular (AC) separations. These injuries are the second most common type of dislocation to occur around the shoulder girdle at an overall incidence of almost 4 per 100,000 in the general population. The vast majority of AC separations (grades I, II, III) do very well with conservative treatment (Figure 1). Grades IV-VI are uncommon and are usually the result of a very high-energy injury which may need surgical repair (Figure 1). Yet, standard method for treating this common injury is still lacking, with more than sixty different surgical reconstruction techniques described.