scholarly journals Editorial Comment on: W. Krzyżanowski The use of ultrasound in the assessment of the glenoid labrum of the glenohumeral joint. Part I: Ultrasound anatomy and examination technique and W. Krzyżanowski, M. Tarczyńska The use of ultrasound in the assessment of the glenoid labrum of the glenohumeral joint. Part II: Examples of labral pathologies

2012 ◽  
Vol 12 (51) ◽  
pp. 500-503
Author(s):  
Jan Franiel ◽  
Keyword(s):  
Editorial Comment ◽  
Glenohumeral Joint ◽  
Glenoid Labrum ◽  
Examination Technique

Shoulder Instability and the Labrum

2018 ◽  
pp. 171-214
Author(s):  
Joaquin Sanchez-Sotelo
Keyword(s):  
Rotator Cuff ◽  
Range Of Motion ◽  
Shoulder Instability ◽  
Glenohumeral Joint ◽  
Biceps Tendon ◽  
Posterior Instability ◽  
Joint Dislocation ◽  
Glenoid Labrum ◽  
Multidirectional Instability ◽  
Labral Tears

The glenohumeral joint architecture allows for a very ample range of motion. This same architecture, so beneficial for shoulder mobility, also makes the glenohumeral joint particularly prone to instability. Damage to the glenoid labrum is present in many patients with shoulder instability, although the complexity of the pathology involved in shoulder instability goes beyond labral tears. The rotator cuff and the biceps tendon, discussed in chapter 6, The Rotator Cuff and Biceps Tendon, are intimately involved with instability and the labrum; some of the concepts described in chapter 6 will apply here as well. This chapter covers shoulder instability and the labrum, including management of the acute glenohumeral joint dislocation, recurrent posterior instability and posterior labral tears, multidirectional instability, superior labral tears, failed instability surgery, and salvage procedures.

scholarly journals The use of ultrasound in the assessment of the glenoid labrum of the glenohumeral joint. Part II: Examples of labral pathologies

2012 ◽  
Vol 12 (50) ◽  
pp. 329-341 ◽  
Author(s):  
Wojciech Krzyżanowski ◽  
◽  
Marta Tarczyńska ◽  
◽  
Keyword(s):  
Glenohumeral Joint ◽  
Glenoid Labrum

The Impact of Glenoid Labrum Thickness and Modulus on Labrum and Glenohumeral Capsule Function

2010 ◽  
Vol 132 (12) ◽  
Author(s):  
Nicholas J. Drury ◽  
Benjamin J. Ellis ◽  
Jeffrey A. Weiss ◽  
Patrick J. McMahon ◽  
Richard E. Debski
Keyword(s):  
Finite Element ◽  
Glenohumeral Joint ◽  
External Rotation ◽  
Tensile Modulus ◽  
Activity Levels ◽  
Average Strain ◽  
Glenoid Labrum ◽  
Age Related ◽  
Glenohumeral Capsule ◽  
The Impact

The glenoid labrum is an integral component of the glenohumeral capsule’s insertion into the glenoid, and changes in labrum geometry and mechanical properties may lead to the development of glenohumeral joint pathology. The objective of this research was to determine the effect that changes in labrum thickness and modulus have on strains in the labrum and glenohumeral capsule during a simulated physical examination for anterior instability. A labrum was incorporated into a validated, subject-specific finite element model of the glenohumeral joint, and experimental kinematics were applied simulating application of an anterior load at 0 deg, 30 deg, and 60 deg of external rotation and 60 deg of glenohumeral abduction. The radial thickness of the labrum was varied to simulate thinning tissue, and the tensile modulus of the labrum was varied to simulate degenerating tissue. At 60 deg of external rotation, a thinning labrum increased the average and peak strains in the labrum, particularly in the labrum regions of the axillary pouch (increased 10.5% average strain) and anterior band (increased 7.5% average strain). These results suggest a cause-and-effect relationship between age-related decreases in labrum thickness and increases in labrum pathology. A degenerating labrum also increased the average and peak strains in the labrum, particularly in the labrum regions of the axillary pouch (increased 15.5% strain) and anterior band (increased 10.4% strain). This supports the concept that age-related labrum pathology may result from tissue degeneration. This work suggests that a shift in capsule reparative techniques may be needed in order to include the labrum, especially as activity levels in the aging population continue to increase. In the future validated, finite element models of the glenohumeral joint can be used to explore the efficacy of new repair techniques for glenoid labrum pathology.

Outcomes of Arthroscopic Repair of Panlabral Tears of the Glenohumeral Joint

2012 ◽  
Vol 40 (11) ◽  
pp. 2561-2568 ◽  
Author(s):  
Eric T. Ricchetti ◽  
Michael C. Ciccotti ◽  
Daniel F. O’Brien ◽  
Matthew J. DiPaola ◽  
Peter F. DeLuca ◽  
...  
Keyword(s):  
Revision Surgery ◽  
Glenohumeral Joint ◽  
Case Series ◽  
Arthroscopic Repair ◽  
Labral Repair ◽  
Glenoid Labrum ◽  
Superior Labrum ◽  
Shoulder Score ◽  
Anterior Posterior

Background: Combined lesions of the glenoid labrum involving tears of the anterior, posterior, and superior labrum have been infrequently reported in the literature. Purpose: To evaluate the clinical outcomes of arthroscopic repair of these lesions in a general population using validated scoring instruments, presence of complications, and need for revision surgery. Study Design: Case series; Level of evidence, 4. Methods: Fifty-eight patients who had arthroscopic labral repair of tears involving the anterior, posterior, and superior labrum (defined as a panlabral repair) were identified at our institution by retrospective review. All patients underwent arthroscopic labral repair with suture anchor fixation by a uniform approach and with a standardized postoperative protocol. Forty-four patients had a minimum 16-month postoperative follow-up. Outcomes were assessed postoperatively by the American Shoulder and Elbow Surgeons (ASES) score and the Penn Shoulder score. Complications were also documented, including need for revision surgery. Results: The mean age at the time of surgery was 32 years (range, 15-55 years) in the 44 patients. Presenting shoulder complaints included pain alone (40%), instability alone (14%), or pain and instability (45%). Mean number of anchors per repair was 7.9 (range, 5-12). Mean follow-up was 42 months (range, 16-78 months). Mean ± standard deviation ASES score at final follow-up was 90.1 ± 17.7 (range, 22-100), and mean Penn Shoulder score was 90.2 ± 15.3 (range, 38-100). Three of the 4 patients with outcome scores of 70 or less at final follow-up had undergone prior surgery. Thirteen postoperative complications (30%) occurred, with 3 (7%) requiring a second surgery. Five patients (11%) had an instability event following panlabral repair, but only 1 of these patients (2%) required revision surgery for a recurrent labral tear. Conclusion: Combined tears of the anterior, posterior, and superior glenoid labrum represent a small but significant portion of labral injuries. Arthroscopic repair of these injuries can be performed with good postoperative outcomes and a low rate of recurrent labral injury.

scholarly journals Shoulder: Instability

2021 ◽  
pp. 1-9
Author(s):  
Michael J. Tuite ◽  
Christian W. A. Pfirrmann
Keyword(s):  
Glenohumeral Joint ◽  
External Rotation ◽  
Rotator Cuff Tears ◽  
Glenoid Fossa ◽  
Glenohumeral Instability ◽  
Glenoid Labrum ◽  
Glenohumeral Ligaments ◽  
Labral Tears ◽  
The Stability ◽  
Spinoglenoid Notch

AbstractGlenohumeral instability is the inability to keep the humeral head centered in the glenoid fossa. Glenohumeral instability can be classified according to etiology and direction of instability. The glenoid labrum, the glenohumeral ligaments, and the bony structures contribute to the stability glenohumeral joint and need to be addressed with imaging. One of the difficulties with accurately diagnosing labral tears on MR imaging is the normal labral variants, which can sometimes appear similar to tears. The location and extent of a Hill-Sachs lesion and glenoid rim defects need to be related to recognize engaging Hill-Sachs lesions or off-track situations. There are several types of labral tears that are not associated with a prior dislocation. SLAP tears are one of the more common tears of the labrum and can sometimes be difficult to distinguish from a normal variant superior sublabral recess. Labral tears in overhead thrower occur in the posterosuperior labrum, adjacent to the posterior rotator cuff tears in these athletes. Tears in the posterosuperior labrum are also associated with spinoglenoid notch paralabral cysts, which can be painful and cause external rotation weakness.

scholarly journals Age related morphometric changes of the glenoid labrum

2020 ◽  
Vol 14 (3) ◽  
pp. 177-184
Author(s):  
Abduelmenem ALASHKHAM ◽  
Abdulrahman ALRADDADI ◽  
Roger SOAMES
Keyword(s):  
Glenohumeral Joint ◽  
Statistical Significance ◽  
Joint Stability ◽  
Chi Square ◽  
Glenoid Labrum ◽  
Age Related ◽  
Significant Difference ◽  
Males And Females ◽  
Chi Square Tests

Objectives: Although the glenoid labrum is linked to glenohumeral joint stability, its anatomy remains controversial. This study aimed to investigate the shape, consistency of the glenoid labrum, and whether these and its thickness and depth are age related. Methods: A total of 140 shoulders were dissected to expose the glenoid labrum. the shape and consistency of the glenoid labrum were assessed at a gross level. Measurements were taken of the labrum depth and thickness, using callipers, in the superior, anterior, inferior and posterior regions. ANOVA and chi-square tests were conducted to determine statistical significance, which was set at p<0.05. Results: The consistency of the superior half of the labrum was rubbery in 97.9% of specimens and firm in the remaining 2.1%, whereas the entire inferior half was firm. There was a significant difference (p=0.043) in the consistency of the superior half between males and females. The superior half was triangular in 95.7% of specimens, flat in 2.1% and flat to triangular in 2.1%, whereas the shape of the inferior half was rounded in 99.3% of specimens and flat in 0.7%. The labrum was observed to be thicker in younger individuals, with the differences being significant superiorly (p=0.011), anteriorly (p=0.050), inferiorly (p=0.001) and posteriorly (p=0.047). It was also observed to be deeper in younger individuals, but only significantly so superiorly (p=0.044). Conclusion: Labrum thickness and depth significantly decreased with increasing age, suggesting that these observations could be age-related.

scholarly journals The successful arthroscopic treatment of suprascapular intraneural ganglion cysts

2015 ◽  
Vol 39 (3) ◽  
pp. E11 ◽  
Author(s):  
Nikhil K. Prasad ◽  
Robert J. Spinner ◽  
Jay Smith ◽  
Benjamin M. Howe ◽  
Kimberly K. Amrami ◽  
...  
Keyword(s):  
High Resolution ◽  
Glenohumeral Joint ◽  
Suprascapular Nerve ◽  
Arthroscopic Repair ◽  
Open Approach ◽  
Intraneural Ganglion ◽  
Surgical Morbidity ◽  
Nerve Branch ◽  
Glenoid Labrum ◽  
Ganglion Cysts

OBJECT High-resolution magnetic resonance imaging (MRI) can distinguish between intraneural ganglion cysts and paralabral (extraneural) cysts at the glenohumeral joint. Suprascapular intraneural ganglion cysts share the same pathomechanism as their paralabral counterparts, emanating from a tear in the glenoid labrum. The authors present 2 cases to demonstrate that the identification and arthroscopic repair of labral tears form the cornerstone of treatment for intraneural ganglion cysts of the suprascapular nerve. METHODS Two patients with suprascapular intraneural ganglion cysts were identified: 1 was recognized and treated prospectively, and the other, previously reported as a paralabral cyst, was identified retrospectively through the reinter-pretation of high-resolution MR images. RESULTS Both patients achieved full functional recovery and had complete radiological involution of the intraneural ganglion cysts at the 3-month and 12-month follow-ups, respectively. CONCLUSIONS Previous reports of suprascapular intraneural ganglion cysts described treatment by an open approach to decompress the cysts and resect the articular nerve branch to the glenohumeral joint. The 2 cases in this report demonstrate that intraneural ganglion cysts, similar to paralabral cysts, can be treated with arthroscopic repair of the glenoid labrum without resection of the articular branch. This approach minimizes surgical morbidity and directly addresses the primary etiology of intraneural and extraneural ganglion cysts.

scholarly journals COMPARISON OF TH E RESULTS OF GLENOHUMERAL JOINT RADIOGRAPH IMAGES DESCRIPTION ON AP OBLIQUE WITH 15O, 25O, 30O, AND HORIZONTAL ANGULAR BEAM

2020 ◽  
Vol 9 (1) ◽  
pp. 24-27
Author(s):  
Saleh Mursyid
Keyword(s):  
Glenohumeral Joint ◽  
Glenoid Fossa ◽  
Design Data ◽  
Examination Technique ◽  
Horizontal Beam ◽  
Comparison Research ◽  
Joint Gap ◽  
Quantitative Design ◽  
Oblique Images ◽  
Body Joint

Glenohumeral joint is the broadest joint in our body. Joint glenohumeral joints bullet includes joint with very shallow bowls. The examination technique to see the glenohumeral joint is with the AP position, RPO and LPO formed the Oblique patient position with 15o, 25o, 30o and horizontal angular beam. This comparison research to know the results of Glenohumeral Joint Radiograph Oblique images on AP with of 15o, 25o, 30o and angular horizontal beam at the Radiology Installation of Ulin Banjarmasin Hospital. This research is descriptive quantitative design. Data collected by observing, and based on the results of questionnaires that distributed to 20 respondents to see the results of comparison Glenohumeral Joint Radiograph on AP Oblique images with of 15o, 25o, 30o and angular horizontal beam at the Radiology Installation of Ulin Banjarmasin Hospital. Using a horizontal beam angular direction is better Because The joint gap between the head of the humerus and the glenoid fossa is completely open and there is a very clear images of the glenoid fossa. There are differences in the Joint Glenohumeral on AP Oblique radiographs with 15o, 25o, 30o and horizontal angular beam.

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