The coracoacromial ligament spans from the coracoid to the acromion creating the coracoacromial arch through which the supraspinatus tendon passes. Subacromial decompression releases this ligament to enlarge the space. Its partial preservation during acromioplasty maintains the restraint against superior head escape in massive rotator cuff tears.
| Origin | Lateral coracoid process |
|---|---|
| Insertion | Anterior inferior acromion |
| Actions | Forms the roof of the subacromial space; prevents superior humeral head escape in massive cuff tears |
|---|
Full coracoacromial ligament release during acromioplasty in the presence of a massive irreparable rotator cuff tear can produce anterosuperior escape of the humeral head — the acromion-humeral distance collapses and the shoulder loses functional elevation. Selective partial release at the acromial edge preserves the anterior arch as a secondary stabiliser.
Coracoacromial arch compression of the supraspinatus tendon producing painful arc managed with physiotherapy, injection, and arthroscopic decompression.
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