In certain patients, inpingement and AC joint pain can co-exist. This procedure involves removing roughly 3/8 inch of the end of the clavicle, which creates a permanent gap so the two bones no longer come in contact with each other. Pain is eliminated because the bones no longer rub, but the strength and stability of the joint is not compromised, as the ligaments are undisturbed. When the procedure is done arthroscopically, a video camera and small specialized tools are inserted through a series of small incisions to shave down the end of the clavicle until a significant joint space is created between the clavicle and the acromion. If the procedure is done through an open incision on the top of the shoulder, the end of the clavicle is cut out to create a larger AC joint space and then the surrounding soft tissues and skin are sutured closed.