The Archives of Bone and Joint Surgery

The Archives of Bone and Joint Surgery

Coracoacromial Ligament Release Improves Internal Rotation in Reverse Total Shoulder Arthroplasty; a Cadaver Study

Document Type : RESEARCH PAPER

Authors
Feras Qawasmi 1
Abrar Abuhamdia 2
Logan M. Andryk 1
Steven Grindel 1
Mustafa Yassin 1
1 Medical College of Wisconsin, Department of Orthopaedic Surgery, Milwaukee, WI, USA
2 Division of Genomics and Precision Medicine, College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
10.22038/abjs.2025.84191.3827
Abstract
Objectives: Evaluate the effect of Coracoacromial Ligament (CAL) release after Reverse shoulder arthroplasty (RSA) on range of motion (ROM), particularly on internal rotation (IR).
Methods: Ten Fresh Frozen cadavers underwent RSA followed by CAL release by a fellowship-trained surgeon. Shoulder ROM was measured by a goniometer pre- and post-CAL release. The IR to the back was measured as the distance between the posterior-lateral acromion and the highest point of thumb elevation behind the back. Measurements of ROM before and after CAL release were compared using a paired sample t-test.
Results: CAL release after RSA significantly increased ROM in all planes. The IR to the back improved by an average of four cm. Internal rotation in abduction, external rotation in abduction, external rotation at the side, forward elevation, abduction, and extension increased by 7°, 8°, 9°, 10°, 6°, 11°, respectively.
Conclusion: The CAL release following RSA significantly improved IR to the back and all other ROM. CAL release post-RSA could be a potential solution to the ROM deficits, particularly IR, post-RSA. Clinical studies are needed to assess the clinical application of this technique.
        Level of evidence: IV
Keywords
Coracoacromial ligament
Internal rotation
Range of motion
Reverse total shoulder arthroplasty
Subjects
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The Archives of Bone and Joint Surgery
Volume 14, Issue 5
May 2026
Pages 337-342

  • Receive Date 01 December 2024
  • Revise Date 21 January 2025
  • Accept Date 07 January 2025