Friday, February 14, 2020

"Coracoid impingement" - is this something to worry about?

Coracoid morphology is not associated with subscapularis tears

The authors point out that prior authors suggested coracoid morphology may be related to subscapularis pathology. 

This illustration proposes a "roller wringer" phenomenon

This MRI is thought to show a decreased coracohumeral space and complete tear of the subscapularis tendon. 

These authors examined MRIs of 201 patients 45 years or older who underwent shoulder arthroscopy for any indication, measuring the coracohumeral distance (CHD), lateral extent (LE), and caudal extent (CE) of the coracoid process. Patients’ subscapularis condition was assessed via operative reports; stratified according to Lafosse grade criteria.

112 patients had no evidence of subscapularis injury, whereas Lafosse grade I injuries were identified in 52 patients; grade II, in 19; and grades III-V, in 18. 

The CHD, LE, and CE were not correlated with the degree of subscapularis injury

They concluded that coracoplasty may not be necessary prophylactically or as part of subscapularis repair.

We have a new set of shoulder youtubes about the shoulder, check them out at this link.

Be sure to visit "Ream and Run - the state of the art" regarding this radically conservative approach to shoulder arthritis at this link and this link

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