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The fate of the coracohumeral ligament in rotator cuff tears
Author(s) -
Hirtler Lena,
Unerfusser Lukas
Publication year - 2021
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.2021.35.s1.03384
Subject(s) - rotator cuff , medicine , tears , shoulders , cuff , rotator cuff injury , ligament , surgery , shoulder girdle , shoulder joint , anatomy
Rotator cuff tears are the most common cause for pain and dysfunction in the shoulder girdle. Located in the subacromial space, the small rotators of the shoulder joint merge into a thick tendinous cuff, which shows high relevance in the biomechanics of the shoulder joint. Correlating with age, rotator cuff lesions can be caused by intrinsic and extrinsic factors. There is a wide consent that the coracohumeral ligament itself is a part of the rotator cuff. Its role, in terms of pathogenesis, diagnostic and treatment of rotator cuff tears, is still unknown. Material and Methods 40 fresh frozen shoulders were dissected and examined. The existence of rotator cuff tears was the objective of that process. Lesions as well as the morphology of the cuff and the coracohumeral ligament were photographically documented, measured computer‐assisted and statistically analyzed. Results In 27.5% of all shoulder joints, a rotator cuff tear was observed. In addition, there was an increase of rotator cuff tears with advancing age. Statistical analysis revealed no significant difference in the sex distribution and measured tear‐area in ruptured cuffs and coracohumeral ligament (female: p=0.463, male: p=0.336). A significant connection (p=0.001) between the prevalence of rotator cuff tears and ruptures of the coraohumeral ligament was found. There was no intact coracohumeral ligament in shoulders with a damaged rotator cuff. However, ruptured coracohumeral ligaments were found in joints with uninjured tendons. Conclusion Apart from a significant connection (p=0.001) between the prevalence of rotator cuff tears and ruptures of the coracohumeral ligament this study is the first to suggest that the coracohumeral ligament ist one of the first structures damaged in the degeneration of the rotator cuff. The results presented in this study imply that the degeneration of the rotator cuff occurs from bursal towards the subacromial space, which is contrary to the classic Impingement‐Syndrome‐Theory.