Sensitivity of Preoperative Magnetic Resonance Imaging and Magnetic Resonance Arthrography in Detection of Panlabral Tears of the Glenohumeral Joint

Ricchetti, Eric T.; Ciccotti, Michael C.; Williams, Gerald R.; Lazarus, Mark D.

doi:10.1016/j.arthro.2012.10.005

Cited by 18 publications

(16 citation statements)

References 29 publications

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“…2 The true extent of such extensive tears is frequently missed on noncontrast MRI and MR arthrography, thus, leading to problems with diagnosis, which further complicate treatment and outcomes. 4 Arthroscopic labral repair is the most common treatment for glenohumeral instability, providing excellent outcomes for anterior and posterior instability with high levels of patient satisfaction and high rates of return to sport. 5 However, when it comes to more extensive tears, arthroscopic treatment has less favorable outcomes; concerns regard recurrent instability and stiffness.…”

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confidence: 99%

Return to Sport Following Arthroscopic Repair of 270° Labral Tears

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Hurley

Ali

et al. 2020

Arthroscopy, Sports Medicine, and Rehabilitation

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To evaluate the rate of return to sport following arthroscopic repair of 270 labral tears. Methods: We performed a retrospective review of patients with 270 labral tears treated arthroscopically between 2013 and 2017 by a single surgeon. Patients were followed-up to assess whether they were able to return to sport, the level to which they returned and the timing of return. Complications, the Visual Analogue Scale for pain (VAS), the Rowe score, the Shoulder Instability-Return to Sport after Injury (SIRSI) score, and the Subjective Shoulder Value (SSV) were recorded. Results: The study included 25 patients, with a mean follow-up of 42.2 AE 16.5 months. Of the 25 patients, 19 (76.0%) returned to sport at a mean of 6.8 AE 2.6 months, while 15 (60%) returned at the same or a higher level. At final follow-up, the mean Rowe score was 80.6 AE 14.2; the mean SIRSI score was 61.8 AE 25.4; the mean SSV was 86.4 AE 15.2; and the mean VAS score was 2.2 AE 2.0. One patient reported recurrent subluxation, but no patients suffered a recurrent dislocation during the study period. No revision surgeries were performed within the study period. Conclusion: Patients with 270 labral tears who were treated with arthroscopic repair showed an overall high rate of return to sport. Despite a low rate of recurring instability, not all patients were able to return to their previous levels of sports. Level of evidence: Level IV, therapeutic case series.

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confidence: 99%

Return to Sport Following Arthroscopic Repair of 270° Labral Tears

Pounder

Hurley

Ali

et al. 2020

Arthroscopy, Sports Medicine, and Rehabilitation

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“…The triple labral lesion of the shoulder is not easily detected by the available imaging methods; it can be diagnosed in up to 32.3% of cases when MRI arthrogram is used and in 8.7% when MRI is used 16 . This fact is probably due to the difficulty in diagnosing SLAP lesions, as demonstrated by Godinho et al 5 …”

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confidence: 99%

Functional outcome after arthroscopic repair of triple shoulder instability

Godinho

França

Freitas

et al. 2017

Revista Brasileira de Ortopedia (English Edition)

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ObjectiveTo evaluate the functional outcomes of patients submitted to arthroscopic repair of triple labral lesion.MethodsThis was an analytical retrospective study of patients who underwent arthroscopic treatment of triple labral lesion from March 2005 to December 2014. Patients with at least one year of postoperative follow-up were included. A total of nine patients were evaluated. The mean age was 32.3 years and the dominant side was affected in five patients. Patients were functionally assessed regarding the range of motion (ROM) in elevation, external rotation with the arm close to the body the arm in abduction of 90°, and internal rotation, and by the Carter–Rowe score. The degree of satisfaction was assessed at the end of the follow-up period.ResultsThree patients had less than five episodes of instability, four patients had between five and ten episodes, and two patients had more than ten episodes. Seven patients had positive O’Brien test for SLAP lesions and positive apprehension test in abduction and external rotation, and only one patient had apprehension in adduction and internal rotation. Three patients persisted with positive O’Brien test and one with apprehension in abduction and external rotation at the end of follow-up. The range of motion was complete in all cases. The median Carter–Rowe score increased from 40 preoperatively to 90 (p = 0.008).ConclusionThe arthroscopic repair of triple labral lesions allows for the restoration of the stability of the glenohumeral joint, achieving excellent functional results.

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“…2,3 Their description of 6 level IV articles regarding 360 and 270 labral tears is a constant reminder that, when it comes to treating large labral tears, expect heterogeneity but depend on core anatomic principles. [4][5][6][7][8][9] As first conceptualized by Warren et al, the circle model of shoulder stability postulates that, to create shoulder instability, the capsulolabral complex of the shoulder must be disrupted in 2 places. 10,11 Therefore, a panlabral lesion or 270 tear may represent a readily identifiable manifestation of this model.…”

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confidence: 99%

“…14 Because of the continually proven tendency of magnetic resonance imaging to underdiagnose labral tears, surgeons must be prepared to encounter a larger labral lesion than reported on magnetic resonance imaging. 9 Finally, surgeons must have a high index of suspicion for tear propagations in instability patients who report constant pain, even in between instability events. 12 Armed with these core insights, the orthopaedist can embrace the heterogeneity of large labral injuries and find comfort that successful treatment is dependent on restoring the anatomy.…”

Section: Brown Universitymentioning

confidence: 99%

Editorial Commentary: Treatment of Panlabral Shoulder Lesions: The Circle Concept Revisited

Bokshan

Owens

2020

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Shoulder instability is common in athletes. Combined labral injuries are also common and appear more frequently in chronic cases, suggesting propagation of smaller tears with each event. Panlabral tears, or 270 tears, represent an extreme form of this phenomenon. Arthroscopy has allowed for improved appreciation of these combined patterns. Although it is essential to fix all labral lesions identified during arthroscopy, it is also crucial to enter surgical cases with a clear diagnosis (i.

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Sensitivity of Preoperative Magnetic Resonance Imaging and Magnetic Resonance Arthrography in Detection of Panlabral Tears of the Glenohumeral Joint

Cited by 18 publications

References 29 publications

Return to Sport Following Arthroscopic Repair of 270° Labral Tears

Return to Sport Following Arthroscopic Repair of 270° Labral Tears

Functional outcome after arthroscopic repair of triple shoulder instability

Editorial Commentary: Treatment of Panlabral Shoulder Lesions: The Circle Concept Revisited

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