Coracoacromial ligament preservation in rotator cuff surgery

Reversed arthroscopic subacromial decompression for massive rotator cuff tears

“…6 In addition to the dynamic action of the remaining rotator cuff, many authors have focused on the importance of the coracoacromial arch as an important passive stabilizer against anterosuperior displacement of the humeral head. 10,11,30 Two cadaveric studies have shown that release of the coracoacromial ligament leads to a significant superior translation of the humeral head, which further increases after anterior acromioplasty. 22,24 Although the role of an intact coracoacromial arch is obvious, the previously mentioned clinical studies would indicate that subacromial decompression and, in particular, relieving the impingement are of primary importance in eliminating the pain and perhaps in improving the function in patients with massive rotator cuff tears.…”

“…6,8,29 Cadaveric and clinical studies have focused on the importance of the coracoacromial arch as a passive stabilizer against anterior and superior humeral displacement, particularly in the presence of massive rotator cuff tears. 10,11,22,24,30,34 To maintain the integrity of the coracoacromial arch and avoid the potential destabilizing effect of the acromioplasty, Fenlin et al 9 recently published their experience using open debridement with an isolated tuberoplasty for massive, irreparable rotator cuff tears. This procedure relieves subacromial impingement by creating an articulation between the greater tuberosity and the undersurface of the acromion.…”

Pathogenesis of partial tear of the rotator cuff: A clinical and pathologic study

“…19,20,26 Rockwood and Williams 27 and others 2,8,9,12,16 emphasized the importance of adequate decompression, which when insufficient, usually was the reason for failed treatment in rotator cuff lesions. On the other hand, Flatow et al 10,11 cautioned that superior stability of the shoulder in patients with massive rotator cuff tears was dependent on an intact coracoacromial arch. Goldberg et al 15 reported improvement in comfort and function after cuff repair without acromioplasty in 27 patients at a minimum follow-up of 2 years.…”

Open reduction and internal fixation of os acromion fracture-separation as a component of a floating shoulder injury: A case report

“…1 The CAL was preserved in this patient because it is an important buffer against superior humeral head translation and was part of a floating shoulder injury. 6,7 In addition, preservation of the acromioclavicular ligaments to lend stability to the os fragment has been recommended. 15 This was even more crucial with this patient's displaced os/ floating shoulder injury pattern because the acromioclavicular ligaments were attached not only to the os fragment but also to the distal clavicle, CAL, coracoclavicular ligaments, and coracoid/superior glenoid fragment.…”