THE ANATOMIC CONSEQUENCES OF ARTHROSCOPIC CORACOPLASTY:
AN ANATOMIC DISSECTION STUDY
Aruna Seneviratne, MD; Ken Montgomery, MD; Babette Bevilacqua, PAC; Bashir A Zikria, MD
Lenox Hill Hospital, New York, NY, USA
Results:
Objective:
Average coracoplasty from coracoid tip: 10.3mm
Figure 1
Arthroscopic coracoplasty is a surgical technique that
Structure and Approximate Orientation Relative to Coracoid
Tip (Normalized to a Right Shoulder)
has recently been described to treat subcoracoid
CCL
35
30
25
20
15
10
5
0
impingement. The goal of this investigation was to
determine the anatomy of the soft tissue attachments
onto the coracoid, and to assess how these structures
may be compromised after an arthroscopic reduction of
CAL
the coracoid tip.
structure. 7/14 tendons demonstrated perforations (Figures
2 and 3). On average, the conjoint tendon perforation
Coracoid Tip
PMT
The coracobrachialis tendon was the most vulnerable
CAL - Coraco-acromial
Ligament
CCL - Coraco-clavicular
Ligament
CJT - Conjoined Tendon
MCN - Musculocutaneous
Nerve
PMT - Pectoralis Minor Tendon
measured 4.9mm, with the largest perforation being 10mm
(47.6% of the tendon width).
1/14 pectoralis minor tendons were injured. The CA and
CC ligaments were not affected by coracoplasty.
The musculocutaneous nerve was an average of 33 mm
from tip (Figure 1). No nerve injuries were observed.
Figure 3
CJT
MCN
Distance to Tip
Methods:
Figure 2
Average Width of Key Structures
Anatomic dissections were performed on fourteen
25.0
cadaver shoulders to determine the soft tissue
attachments onto the coracoid process (Figure 1). An
within the glenohumoral joint with the shaver placed in
the rotator interval, removing 10-12 mm of bone from
the distal coracoid tip. Follow-up dissections were then
Width (mm)
arthroscopic coracoplasty was then performed from
20.0
CAL - Coraco-acromial
Ligament
CCL - Coracoclavicular Ligament
CJT - Conjoined Tendon
MCN Musculocutaneous
Nerve
PMT - Pectoralis Minor
15.0
10.0
5.0
Width
CJT Violation (mm)
performed to evaluate the consequence of the
Conclusions:
Arthroscopic coracoplasty is a procedure that can be safely and
effectively performed through a rotator interval approach.
Subperiosteal elevation of the coracobrachialis tendon occurs
0.0
coracoplasty on the soft tissues inserting on the coracoid
CJT
PMT
CCL
CAL
during the procedure. Care must taken to remove only coracoid
Structure
bone, leaving the superficial periosteal sleeve of the
coracobrachialis intact, in order to prevent complete
detachment of the coracobrachialis tendon.