Glenoid Labrum

Anterior glenohumeral instability: Current review with technical pearls and pitfalls of arthroscopic soft-tissue stabilization

“…GHJ stability is provided through a complex interplay of passive and dynamic stabilizers[ 1 , 15 - 19 ]. Passive stabilizers include the rotator interval [superior glenohumeral ligament (SGHL), coracohumeral ligament, and joint capsule], the middle glenohumeral ligament (MGHL), and most importantly the inferior glenohumeral ligament complex (IGHL)[ 20 ].…”

“…Passive stabilizers include the rotator interval [superior glenohumeral ligament (SGHL), coracohumeral ligament, and joint capsule], the middle glenohumeral ligament (MGHL), and most importantly the inferior glenohumeral ligament complex (IGHL)[ 20 ]. The glenoid labrum runs circumferentially along the glenoid rim and serves as the point of insertion for all of the GH ligaments[ 1 ]. The SGHL prevents inferior translation of the adducted shoulder, the MGHL resists anterior translation in the externally rotated shoulder in abduction up to 45 degrees, and the IGHL can be broken down into the anterior band which is the major restraint to anteroinferior translation in external rotation with abduction > 45 degrees and the posterior band which resists posterior translation in the flexed and internally rotated shoulder[ 1 , 20 - 25 ].…”

“…The glenoid labrum runs circumferentially along the glenoid rim and serves as the point of insertion for all of the GH ligaments[ 1 ]. The SGHL prevents inferior translation of the adducted shoulder, the MGHL resists anterior translation in the externally rotated shoulder in abduction up to 45 degrees, and the IGHL can be broken down into the anterior band which is the major restraint to anteroinferior translation in external rotation with abduction > 45 degrees and the posterior band which resists posterior translation in the flexed and internally rotated shoulder[ 1 , 20 - 25 ]. The labrum deepens the glenoid socket and acts as a physiologic bumper to prevent GHJ instability[ 1 ].…”

“…The SGHL prevents inferior translation of the adducted shoulder, the MGHL resists anterior translation in the externally rotated shoulder in abduction up to 45 degrees, and the IGHL can be broken down into the anterior band which is the major restraint to anteroinferior translation in external rotation with abduction > 45 degrees and the posterior band which resists posterior translation in the flexed and internally rotated shoulder[ 1 , 20 - 25 ]. The labrum deepens the glenoid socket and acts as a physiologic bumper to prevent GHJ instability[ 1 ]. Furthermore, the fibrocartilaginous labrum which circumferentially surrounds the glenoid and provides stabilization to the GHJ is tight in its anteroinferior attachment and loose in the superior attachment with a great deal of anatomic variation[ 1 , 21 ].…”

“…The unique structure of the glenohumeral joint (GHJ) allows for a wide range of motion, but also makes the joint particularly vulnerable to episodes of instability[ 1 ]. Anterior instability is the most common form, accounting for 80%-98% of all GHJ instability events among young, athletic populations particularly during contact sporting events with the shoulder in the abducted and externally rotated position[ 2 - 10 ].…”