• Title/Summary/Keyword: Superior labrum

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SLAP Lesions Classification Diagnosis Management

  • Esch James C.
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 1997.05a
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    • pp.112-120
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    • 1997
  • 1) The superior labrum-biceps complex contributes to shoulder stability. 2) Injuries to the superior labrum Decrease torsional rigidity Place a greater strain on the IGHL 3) Arthroscopy enables diagnosis and treatment of superior labrum lesions.

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Anatomical Analysis of Superior Glenoid and Glenoid Labrum (상부 관절와 및 관절와 순의 해부학적 분석)

  • Choi, Nam-Yong;Song, Hyun-Seok;Yoon, Hyung-Moon;Choi, Seung-Gyun
    • Journal of the Korean Arthroscopy Society
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    • v.14 no.2
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    • pp.102-106
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    • 2010
  • Purpose: The results of the repair for the superior labrum lesions attaching at the superior glenoid have not been satisfactory in every cases. We wanted to analyze the shoulder MRI and the anatomical morphology and pattern of the superior glenoid at which the superior labrum attaches to get anatomical information helpful in treating the superior labrum. Materials and Methods: We analyzed the coronal images of the shoulder MRI of 108 cases taken at our hospital. Average age was 52 years (range, 17~71 years), 55 males and 53 females. On two coronal images behind the attachment of the long head of biceps that the repair of the SLAP was performed at, the length of the attachment of superior labrum and the angle of the supero-lateral glenoid were measured. Results: The average length of the attachment of superior labrum was $9.78{\pm}1.64\;mm$. The average length was $10.1{\pm}1.61mm$ in male, $9.43{\pm}1.6\;mm$ in female. The angle of the supero-lateral glenoid was $89.6{\pm}7.6$ degrees. Conclusion: The attachment of the superior labrum in coronal plane was shorter in posterior spot than anterior. The angle of the supero-lateral glenoid was less in posterior spot.

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Meniscoid-type SuperrJior Labrum Associated with Internal Derangement of Shoulder Joint (견관절내 병변과 동반된 상부관절순의 반월상변형)

  • Choi Chang-Hyuk;Kwun Koing-Woo;Kim Shin-Kun;Lee Sang-Wook;Park Bum-Jin
    • Clinics in Shoulder and Elbow
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    • v.2 no.1
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    • pp.41-46
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    • 1999
  • Glenoid labrum acts as one of static stabilizer of the glenohumeral joint. It deepens the glenoid socket and may also serve as a chock, acting as a wedge in preventing glenohumeral translation. Two types of variations in labral anatomy were noted by Detrisac and Johnson. Type A has a superior labrum that is detached centrally but well attached peripherally. The type B labrum is well attached centrally and peripherally at all sites. A meniscoid-type labrum is thought to be normal unless there are splits or fragmentation of the overlying labral tissue. Meniscoid type labrum is different from SLAP II lesion in that it has a firm anchoring on the superior labrum. We observed four cases that had a meniscoid variant superior labrum, which covered the superior glenoid unusually larger than normal in the arthroscopic treatment of shoulder pathology including instability and rotator cuff diseases. We did arthroscopic reshaping and debridement of meniscoid variant superior labrum combined with pathologic change of the glenohumeral joint. Further study would be required for understanding the mechanism of the development of meniscoid variant labrum and its clinical significance.

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Rare Normal Variation Between Biceps Anchor and Superior Labrum - A Case Report - (상완 이두근 장두의 관절내 부착부위와 상부 관절와 순 간의 드문 변형 - 증례보고 -)

  • Kim, Yong-Ju;Jeong, Hoon;Ha, Jong-Kyoung;Lee, Kwan-Hee;Lee, Woo-Jin
    • Clinics in Shoulder and Elbow
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    • v.12 no.2
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    • pp.245-249
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    • 2009
  • Purpose: Labral lesions and its anatomic variants have been studied by several authors in the last decade. Buford complex and sublabral recess are most common variants. Their recognition is important in order to distinguish them from superior and anterior labral tear. Materials and Methods: We report one case of a 19-year-old female who was mistaken SLAP lesion for normal variant and was treated with arthroscopic surgery. Results: The arthroscopic finding shows rare normal variant of biceps anchor and superior labrum. The biceps long head tendon was inserted at superior labrum and supraspinatus tendon area. This finding was mistaken to SLAP lesion. Conclusion: We report rare normal variant of biceps anchor and superior labrum that was observed during arthroscopic surgery for SLAP lesion.

Superior Labral Dimension of the Glenohumeral Joint on Direct MR Arthrography (MRA): Relationship with Presence of SLAP (Superior Labrum Anterior to Posterior) Lesion (직접 자기공명 견관절 조영술 상에서 상부 관절순의 크기: 상부 관절순 전후방 파열과의 관계)

  • Im, Tae Seong;Choi, Jung-Ah;Oh, Joo Han
    • Investigative Magnetic Resonance Imaging
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    • v.18 no.3
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    • pp.193-199
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    • 2014
  • Purpose : To evaluate the relationship between superior labral dimension of the glenohumeral joint on direct MRA and presence of SLAP lesion. Materials and Methods: IRB approval was obtained and informed consent was waived for this retrospective study. Direct MRA studies of the shoulder in 296 patients (300 shoulders) with arthroscopic surgery were analyzed by two radiologists blinded to the arthroscopic results, which were used as gold standard. One of the radiologists reviewed the images twice (session 1 and 2) for the evaluation of intra-observer variability. Transverse and longitudinal dimensions of superior labrum on coronal T1-weighted images were measured as base and height of the inverted triangular-shaped superior labrum and compared between patients with SLAP lesions vs. non-SLAP patients. Presence of meniscoid labrum was noted. Statistical analysis was done using unpaired t-test. Results: Among 279 patients (283 shoulders), 122 patients (43.1%) had SLAP lesions. The mean base/height of superior labrum in SLAP and non-SLAP patients measured on T1-weighted MR image were 8.8 mm / 5.2 mm, 8.5 mm / 4.9 mm for reader 1; 8.2 mm / 4.9 mm, 8.1 mm / 4.5 mm for session 1 of reader 2; 8.0 mm / 4.8 mm, 7.6 mm / 4.3 mm for session 2 of reader 2. In SLAP group, the mean labral height was larger than non-SLAP group with statistically significant difference (p<0.05). Fifteen patients (5.3%) had meniscoid labrum according to operation records. Conclusion: In patients with SLAP lesion, the height of the superior glenoid labrum on oblique coronal image of MRA was slightly larger than non-SLAP patients. A larger height of superior glenoid labrum may be associated with SLAP lesions.

Arthroscopic Treatment of a Type II Superior Labrum Anterior to Posterior (SLAP) Lesion Combined with a Bankart Lesion: Comparative Study between Debridement and Repair of Type II SLAP Lesion by the Status of Lesion

  • Lee, Sung Hyun;Joo, Min Su;Lim, Kyeong Hoon;Kim, Jeong Woo
    • Clinics in Shoulder and Elbow
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    • v.21 no.1
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    • pp.37-41
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    • 2018
  • Background: The purpose of this study is to evaluate results of superior labrum anterior to posterior (SLAP) repairs and debridement of type II SLAP lesions combined with Bankart lesions. Methods: Between 2010 and 2014, total 58 patients with anterior shoulder instability due to a Bankart lesion combined with a type II SLAP lesion were enrolled. Patients were divided into two groups: group C consisted of 30 patients, each with a communicated Bankart and type II SLAP lesion and group NC consisted of 28 patients, each with a non-communicated Bankart and type II SLAP lesion. Bankart repairs were performed for all patients. SLAP lesions were repaired in group C and debrided in group NC. Clinical results were analysed to compare groups C and NC by using the visual analogue scale pain score, American Shoulder and Elbow Surgeons score, Constant scores, Rowe score for instability and range of motion assessments. Results: The clinical scores were improved in both groups at final follow-up. Also, there were no differences between two groups. No significant difference was found in terms of the range of motion measured at the last follow-up. The number of suture anchors used was significantly higher in group C than in group NC (5.6 vs. 3.8; p=0.021). Conclusions: In this study, it is considered that Bankart repair and SLAP debridement could be a treatment option in patients with a non-communicated type II SLAP lesion combined with a Bankart lesion (study design: IV, therapeutic study, case series).

SLAP병변의 치료시 감별해야 할 상완 이두근 장두와 상부 관절와 순 간의 드문 변형 - 증례보고 -

  • Kim, Yong-Ju;Jeong, Hun;Ha, Jong-Gyeong;Lee, Gwan-Hui;Lee, U-Jin
    • 대한관절경학회:학술대회논문집
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    • 2009.10a
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    • pp.183-187
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    • 2009
  • Labral lesions and anatomic variants have been studied by several authors in the last decade. Buford complex and sublabral recess and foramen are most common variants. Their recognition is important in order to distinguish them from superior and anterior labral tear. We report rare normal variant of biceps anchor and superior labrum that was observed during arthroscopic surgery for SLAP lesion.

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The suture bridge transosseous equivalent technique for Bony Bankart lesion

  • Choe, Chang-Hyeok;Kim, Sin-Geun;Baek, Seung-Hun;Sin, Dong-Yeong
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 2008.03a
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    • pp.178-178
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    • 2008
  • In order to improve static stability and healing of reattached labrum, we combined the advantages of suture bridge and transosseous technique. Using the conventional 3 portal for anterior instability, check stability of bony Bankart and preparation of glenoid bed in 3 way including removal, reshaping or mobilization of bony fragment. Two anchors were inserted to the superior and inferior portion and medial edge of bony Bankart lesion. It usually corresponded to the area of IGHL. Medial mattress sutures were applied around IGHL complex to get enough depth of glenoid coverage using suture hook. Make 3.5mm pushlock anchor hole to the articular edge of glenoid cartilage. Proximal suture bridge was applied at first and then distal suture bridge was inserted to mobilize the labrum in proximal direction. These construction can provide more stable labral repair with wide contact and compression in case of deficient bony stability. It not only avoids technical disadvantage of point contact with anchor fixation, but also decreasing gap formation through cross compression of labrum that couldn't gain even with the transosseous fixation which affords linear compression effect. Additional bony stability could be gained if the the bony fragment was mobilized to the glenoid margin with potential healing bed or reshaped for the good contact with reattached labrum.

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