Rotator interval lesions and their relation to coracoid impingement syndrome

Area of Science:

• Orthopedic Surgery
• Shoulder Biomechanics
• Sports Medicine

Background:

• Impingement of the coracoid process on the rotator interval is a recognized, albeit uncommon, cause of shoulder dysfunction.
• This condition can be associated with specific anatomical variations or injuries, such as calcified ligaments or aberrant tendon insertions.

Purpose of the Study:

• To investigate the clinical presentation, surgical management, and outcomes of patients with coracoid process impingement on the rotator interval.
• To evaluate the efficacy of surgical intervention in alleviating symptoms and improving function in affected shoulders.

Main Methods:

• Retrospective review of 12 patients (14 shoulders) diagnosed with coracoid process impingement over a 10-year period.
• Surgical procedures included rotator interval closure and, in some cases, coracoidplasty.
• Clinical outcomes assessed based on pain, strength, range of motion, and overall patient improvement at an average follow-up of 4.2 years.

Main Results:

• All 12 patients underwent surgical intervention with significant clinical improvement reported.
• Post-operative limitations included persistent moderate pain in 3 patients (4 shoulders) and weakness in 7 patients (9 shoulders).
• Internal rotation was consistently the most limited shoulder movement post-surgery.

Conclusions:

• Surgical management, including rotator interval closure and coracoidplasty, appears effective in improving shoulder function in patients with coracoid process impingement.
• Despite surgical success, residual pain and weakness can persist, and internal rotation may remain limited.
• Further research is needed to reconcile surgical observations with conflicting experimental findings on impingement mechanisms.