Coracoacromial Ligament Detail

ligamentum coracoacromiale detail

The coracoacromial ligament runs from the lateral coracoid process to the anterior-inferior acromion, forming the roof of the subacromial space and completing the coracoacromial arch under which the supraspinatus rotator cuff must pass.

Region: Shoulder

Biomechanics

Function & Actions

Forms the ceiling of the subacromial outlet, prevents superior humeral head escape from beneath the acromion, and provides the structure against which the supraspinatus impinges in subacromial impingement syndrome.

Clinical Relevance

Clinical Notes

The CAL is the primary structure resected in subacromial decompression — arthroscopic acromioplasty includes CAL release from the acromion. In massive irreparable rotator cuff tears with superior migration, preserving the CAL is now recognised as important because it prevents excessive superior escape of the humeral head. CAL transfer to the greater tuberosity is used in superior capsular reconstruction.

Pathology

Common Injuries & Conditions

CAL Impingement on Supraspinatus

Repetitive supraspinatus impingement against the undersurface of the CAL in subacromial impingement syndrome, producing bursal-sided partial thickness cuff tears and treated by CAL release.

CAL Preservation in Massive Cuff Tear

The intact CAL acts as a constraint against superior humeral head escape in massive rotator cuff tears, and its preservation may reduce the rate of superior migration after failed cuff repair.