Variability in attachment of the coracoacromial ligament in relation with its morphology

Abdulrahman Alraddadi (Lead / Corresponding author), Abduelmenem Alashkham, Clare Lamb, Roger Soames

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Purpose: The coracoacromial ligament (CAL) presents with variable morphology and plays a significant role in the development of subacromial impingement syndrome. Sectioning the CAL has been suggested to relieve impingement of the rotator cuff. The aim of the current study was to investigate the CAL attachment in relation with ligament morphology.

Materials and Methods: The CAL was investigated in 220 cadaveric shoulders from 58 males and 59 females, with a median age of 82 years (range 53-102 years). CALs were classified according to three factors: (1) number of bands present; (2) shape; and (3) attachment to the acromial and coracoid processes.

Results: 35 (16%) CALs had a single band, 84 (38%) two bands, and 101 (46%) three or more bands. CAL shape was either broadband (14: 6%), quadrangular (21: 10%), Y-shaped (84: 38%), or multiple-banded (101: 46%). More ligaments were attached to the medial aspect of the acromion (60%) and medial end of the coracoid (75%) than those restricted to the anterior edge of the acromion (40%) and posterior aspect of the coracoid (25%). Multiple-banded ligaments attached significantly more medially at the acromion and coracoid processes, while single band ligament attachments were restricted to the anterior edge of the acromion and posterior aspect of the coracoid process.

Conclusion: The CAL has variable morphology and attachments with interconnections to different structures around the shoulder. CALs with a medial acromial attachment may narrow the subacromial space leading to further shoulder impingement.

Original languageEnglish
Pages (from-to)1323-1330
Number of pages8
JournalSurgical and Radiologic Anatomy
Volume39
Issue number2
Early online date22 Jul 2017
DOIs
Publication statusPublished - Dec 2017

Keywords

  • Coracoacromial ligament
  • Shoulder
  • Subacromial impingement syndrome
  • Rotator cuff tears

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