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Arthroscopically Treated Tears of the Glenoid Labrum

Factors Influencing Outcome

The Hughston Clinic, PC, Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, Louisiana, The Hughston Clinic, PC

Shep J. Friedman, LCDR, MC, USNR

The Hughston Clinic, PC, The Hughston Clinic, PC

Timothy L. Uhl, MS, PT, ATC

Rehabilitation Services of Columbus, Columbus, Georgia,, Rehabilitation Services of Columbus, Columbus, Georgia,

Labral tears and associated glenohumeral ligament in juries were classified and treated arthroscopically in 83 patients. Transverse labral tears were the most com mon. Subtle increased glenohumeral translation was noted in 24% of patients. Glenohumeral ligament injury was present in 58% of the shoulders, with the middle and superior ligaments or middle ligaments alone most commonly involved. These ligament injuries were clas sified into different groups based on severity. Partial excision of the torn labrum was the primary treatment in all patients and was combined with glenohumeral liga ment repair in 9 patients. Seventy-eight patients were available for subjective follow-up evaluation (average, 3.2 years), while 53 patients were objectively evaluated (average followup, 2.8 years). There were 14% excel lent, 71 % satisfactory, and 15% poor results. The main factor associated with poor results was a grade III gle nohumeral ligament injury in which only partial excision of the torn labrum was performed. There was a positive correlation between injury to both the superior and middle glenohumeral ligaments and increased anterior translation demonstrated by preoperative stability test ing at 60° of humeral abduction in neutral rotation. We believe glenohumeral ligament injury is often as sociated with labral tears and arthroscopic partial labral excision is only effective in those patients who have grade I or II (less severe) glenohumeral ligament injuries.

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