Background: High-grade acute (4 weeks) acromioclavicular (AC) joint separation (types III–VI) treatment is still debatable. Hook plate fixation and coracoclavicular (CC) ligament fixation employing a suspensory loop device (tightrope, synthetic ligament, or absorbable polydioxansulfate sling) are now the two modern procedures that are frequently utilised. Both of these methods are said to produce better clinical results.It is debatable if the tight-rope (TR) approach and clavicular hook plate (CHP) are effective in treating acute acromioclavicular joint dislocation. Which approach to treatment for AC joint dislocation is best? That was the goal of this meta-analysis.