Variability of glenoid labral tear patterns: a study of 280 sequential surgical cases

Alexeev, Mikhail; Kercher, James S.; Levina, Yelena; Duralde, Xavier A.

doi:10.1016/j.jse.2021.05.004

Cited by 18 publications

(27 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, these findings indicate that labral injuries associated with glenohumeral instability may have more extensive tissue damage around the glenoid. Taken together, these findings are consistent with anecdotal clinical experience from several centers and from current papers, 3 , 16 , 17 , 18 , 19 , 31 , 32 which suggest that labral injuries that are associated with clinical symptoms may have variable locations of pathology. In addition, the observed injuries may present variable types of injury patterns each of may alter the labral roles that are considered keys in helping confer dynamic concavity/compression for the glenohumeral joint.…”

Section: Discussionsupporting

confidence: 87%

“… 22 Magnetic resonance imaging was considered to be confirmatory but was not used as the single diagnostic criterion due to the demonstrated lack of efficacy as a single diagnostic entity and its poor correlation with clinical symptoms. 19 , 23 , 24 The efficacy and reliability of this diagnostic process for the identification of the clinical diagnosis of a labral injury was shown in a previous study. 20 …”

Section: Methodsmentioning

confidence: 86%

“… 13 , 14 , 15 , 35 , 36 A recent paper did evaluate specific location of labral injuries around the glenoid and used 3 anatomic areas and 10 categories of injury. 19 For this study, the glenoid was divided into 3 areas, based on previous descriptions of classification of labral injuries. Specific criteria were developed to define the areas and categorize the location of the injuries, and all areas of the glenoid face were specifically evaluated to categorize the frequency of each injury in each area.…”

Section: Discussionmentioning

confidence: 99%

“… 2 , 14 , 15 Recent studies, however, demonstrate that injuries in other parts of the labrum, especially the posterior labrum, may be frequent and clinically relevant in both types of labral injuries. 16 , 17 , 18 , 19 Also, a current concepts consensus review suggested that the classical SLAP injury, a detachment from the 11:00 to the 1:00 position on the glenoid, may actually be an adaptive event to allow maximal external rotation in cocking and may not represent clinically significant pathoanatomy. 3 These findings suggest a need for further investigations confirming these new insights and providing improved scholarship regarding the exact extent of the pathoanatomy of the labral injury in all areas of the glenoid and in all types of injury.…”

mentioning

confidence: 99%

See 3 more Smart Citations

Glenoid Labral Injuries Are More Common Posteriorly Than Superiorly and Are Combined Across Multiple Areas of the Glenoid

Kibler

Grantham

Pike

et al. 2022

Arthroscopy, Sports Medicine, and Rehabilitation

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 87%

Section: Methodsmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Glenoid Labral Injuries Are More Common Posteriorly Than Superiorly and Are Combined Across Multiple Areas of the Glenoid

Kibler

Grantham

Pike

et al. 2022

Arthroscopy, Sports Medicine, and Rehabilitation

View full text Add to dashboard Cite

“…Hence, the primary aim of the current study was to investigate postoperative outcomes, specifically pain, function and recurrent instability, in patients following arthroscopic repair of an inferior glenoid labral tear. Secondary aims were to (1) investigate factors that might be associated with inferior glenoid labrum tears such as family history and mechanism of injury, and (2) investigate whether preoperative magnetic resonance imaging (MRI) or magnetic resonance arthrography (MRA) accurately identified inferior labrum tears. The primary hypothesis was that patients with inferior glenoid labrum tears would report similar postoperative pain and function scores to patients with glenoid labrum tears in other locations.…”

Section: Introductionmentioning

confidence: 99%

Arthroscopic repair of inferior glenoid labrum tears (Down Under lesions) produces similar outcomes to other glenoid tears

Page

Fraser-Moodie

Bayne

et al. 2021

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

Purpose Inferior glenoid labral tears are an uncommon but distinct shoulder injury. Only a small number of studies have reported outcomes following arthroscopic repair. The aim of the current study was to report minimum 2-year outcomes following inferior labral repair and to compare outcomes and risk factors associated with the injury to non-inferior labral tears. Whether preoperative MRI or MRA identified inferior labral tears was also assessed. Methods A prospective study of 162 consecutive patients undergoing arthroscopic glenoid labral repair, excluding isolated superior labral tears, was conducted. Of the 130 patients available for follow-up, 18 (13.7%) had an inferior labral tear ("Down Under lesion"), the remainder had anterior, posterior or mixed anterior/posterior lesions that did not include the inferior pole. Mean follow-up time for the Down Under group was 44 months (SD 10, range 27-57), and 30 months (SD 14, range 4-60) for the non-Down Under group. Postoperative outcomes included the Oxford Shoulder Instability Score and recurrent instability. Associations between Down Under lesions and injury mechanism, instability at presentation, recurrent instability and family history were assessed with multivariable logistic regression. Preoperative MRI or MRA reports by radiologists were examined to determine if Down Under lesions were identified. Results Oxford Shoulder Instability Scores indicated that most patients in both groups had little pain or shoulder problems postoperatively (average Oxford Score 41; 48 = no symptoms). Oxford Scores were not significantly different between the Down Under and non-Down Under groups. Four patients (22.2%) in the Down Under group had recurring symptoms (pain and instability) compared to 12 (10.6%) in the non-Down Under group; this difference was not statistically significant (adjusted OR 1.09, 95% CI 0.19,4.77). Family history of shoulder instability was positively associated with a Down Under lesion (adjusted OR 5.0, 95%CI 1.51,16.7). MRI or MRA identified 52.9% of Down Under lesions. Conclusion Down Under lesions were an infrequent type of glenoid labral injury, yet postoperative outcomes were similar to other labral tears. Patients with Down Under lesions had a significant risk factor due to family history of shoulder instability. MRI and MRA could not reliably identify Down Under lesions. Level of evidence Level III.

show abstract

Biomolecule‐releasing bioadhesive for glenoid labrum repair through induced host progenitor cell responses

Nguyên

Vaish

et al. 2022

Journal Orthopaedic Research

View full text Add to dashboard Cite

Glenoid labral tears occur with repetitive dislocation events and are common injuries observed in shoulder arthroscopic procedures. Although surgery can restore shoulder anatomy, repair is associated with poor clinical outcomes, which may be attributed to the poor regenerative capability of glenoid labral fibrocartilage. Thus, this study was designed to assess whether in situ tissue regeneration via biomolecule‐stimulated recruitment of progenitor cells is a viable approach for the regeneration of labral tears. We developed a click chemistry‐based bioadhesive to improve labral repair and reduce local inflammatory responses due to trauma. Additionally, we previously identified the presence of progenitor cells in the human labrum, which can be recruited by platelet‐derived growth factor (PDGF). Thus, we hypothesized that PDGF‐releasing adhesives could induce the regenerative responses of progenitor cells at the injury site to improve labral healing. In a rat glenoid labral tear model, we evaluated the effect of PDGF‐releasing adhesives on promoting progenitor cells to participate in labral tear healing. After 3 and 6 weeks, the labrum was histologically analyzed for inflammatory responses, progenitor cell recruitment, proliferation, and extracellular matrix (ECM) production (collagen and glycosaminoglycan). Our results showed that adhesives alone considerably reduced local inflammatory responses and labral tissue dissolution. PDGF‐releasing adhesives significantly increased progenitor cell recruitment, proliferation, and ECM production. These results demonstrate that by accelerating autologous progenitor cell responses, PDGF‐releasing adhesives represent a novel clinically relevant strategy to improve the healing of glenoid labral tears.

show abstract

Variability of glenoid labral tear patterns: a study of 280 sequential surgical cases

Cited by 18 publications

References 21 publications

Glenoid Labral Injuries Are More Common Posteriorly Than Superiorly and Are Combined Across Multiple Areas of the Glenoid

Glenoid Labral Injuries Are More Common Posteriorly Than Superiorly and Are Combined Across Multiple Areas of the Glenoid

Arthroscopic repair of inferior glenoid labrum tears (Down Under lesions) produces similar outcomes to other glenoid tears

Biomolecule‐releasing bioadhesive for glenoid labrum repair through induced host progenitor cell responses

Contact Info

Product

Resources

About