Acromioclavicular injury is considered as a common athletic shoulder injury. Many of these injuries can be treated nonoperatively but high-grade injuries can result in pain and loss of shoulder function. A numerous operative techniques have been proposed with recent renewed focus on the anatomy of the coracoclavicular ligaments which has led to anatomic reconstructive techniques that show promised results in biomechanical comparisons. These techniques involve reconstruction of the conoid and trapezoid ligaments through anatomically-based tunnels in the clavicle, with preservation of the distal clavicle that improves the biomechanical stability of this construct. The purpose of this study was to evaluate the results of anatomic reconstruction of unstable acromioclavicular joint by using an autogenous semitendinosus graft. All the patients gave the informed consent prior to being included into this study; the study was authorized by the local ethical committee and was performed in accordance with the Ethical standards of the 1964 Declaration of Helsinki as revised in 2000