With a type III separation, the AC ligaments are torn and the AC joint is dislocated. Surgery was designed to repair or reconstruct the ruptured soft tissues. This type of treatment is still used for some patients. But more surgeons prefer nonoperative care today.

With conservative care, the joint is held in place or immobilized with a sling to allow scar tissue to fill in and around the torn capsule. Past studies over the last 30 years haven't been able to show better results with surgery compared to using a sling.

There have been many changes in surgical technique and graft materials in the last 10 years. In the future, we may see the pendulum swing back toward the use of surgery as the preferred initial treatment for type III AC separations. For now immobilization followed by a rehab program seems to be favored by most surgeons.