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The isolated inferior glenohumeral labrum injury, anterior to posterior (the ILAP): A case series.

Irion V, Cheah M, Jones GL, Bishop JY - Int J Shoulder Surg (2015 Jan-Mar)

Bottom Line: Eleven of 12 patients (91.7%) had good or excellent scores.Ten of 12 patients (83.3%) had a feeling of stability in the shoulder.All 12 patients reached were satisfied with the procedure and would undergo surgery again in a similar situation.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, OSU Sports Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA.

ABSTRACT

Introduction: We describe the presentation, exam findings, surgical repair techniques, and short-term outcomes in a series of patients with isolated inferior labral tears.

Materials and methods: A retrospective chart review was performed at a large academic medical center. Isolated inferior labral tears were defined as between the 4 o'clock and 8 o'clock position of the glenoid as determined by direct arthroscopic visualization. Tears that were smaller were also included but were required to cross the 6 o'clock point, having anterior and posterior components. Patients were excluded if they had any other pathology or treatment of the shoulder. 1-year follow-up was required.

Results: Of the 17 patients who met inclusion criteria for review, 12 were available for a minimum 1-year follow-up. Average total follow-up for patients to complete the phone interview/Oxford Shoulder Instability Score (OSIS) was an average of 37.7 months (range: 16-79 months). Postoperatively, all reported symptom improvement or resolution since surgery. The mean preoperative pain on a scale of 0-10 was 6.3 (range: 0-10). Mean postoperative pain on a scale of 0-10 was 2.25 (range: 0-5). Eleven of 12 patients (91.7%) had returned to the level of activity desired. The mean OSIS was 41.4 (median: 43; range: 27-47). Eleven of 12 patients (91.7%) had good or excellent scores. Ten of 12 patients (83.3%) had a feeling of stability in the shoulder. All 12 patients reached were satisfied with the procedure and would undergo surgery again in a similar situation.

Conclusions: We have presented our series of patients with isolated inferior labral injury, and have shown that when surgically treated, outcomes of this uncommon injury are good to excellent and a full return to sports can be expected.

No MeSH data available.


Related in: MedlinePlus

View from anterior-superior portal identifying inferior labral tear and preparation of the glenoid surface at the 6 o'clock position
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Figure 1: View from anterior-superior portal identifying inferior labral tear and preparation of the glenoid surface at the 6 o'clock position

Mentions: Patients were brought to the operating room and placed in the lateral decubitus (JYB) or beach chair position (GLJ) depending on the senior author. Interscalene block with general anesthesia was routinely utilized. After appropriate positioning, an exam under anesthesia was performed and in the case of patients in the lateral decubitus position, 10 pounds of traction was routinely utilized. Standard arthroscopy portals were then established. A diagnostic arthroscopy of the shoulder joint was performed to evaluate the location of the labral injury and any other associated pathology. Once the labral pathology was identified [Figure 1], a second low anterior portal was created with an 8.25 mm cannula to help complete the anterior portion of the repair. The glenoid and labrum were then debrided from anterior to posterior [Figure 1], creating a lightly bleeding surface along the entire labral avulsion, including the 6 o'clock position as viewed from posterior. Next, the camera was placed anterior to view posterior. A 5.0 mm cannula was placed in the viewing portal posteriorly to complete the debridement of the glenoid and labrum.


The isolated inferior glenohumeral labrum injury, anterior to posterior (the ILAP): A case series.

Irion V, Cheah M, Jones GL, Bishop JY - Int J Shoulder Surg (2015 Jan-Mar)

View from anterior-superior portal identifying inferior labral tear and preparation of the glenoid surface at the 6 o'clock position
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4325385&req=5

Figure 1: View from anterior-superior portal identifying inferior labral tear and preparation of the glenoid surface at the 6 o'clock position
Mentions: Patients were brought to the operating room and placed in the lateral decubitus (JYB) or beach chair position (GLJ) depending on the senior author. Interscalene block with general anesthesia was routinely utilized. After appropriate positioning, an exam under anesthesia was performed and in the case of patients in the lateral decubitus position, 10 pounds of traction was routinely utilized. Standard arthroscopy portals were then established. A diagnostic arthroscopy of the shoulder joint was performed to evaluate the location of the labral injury and any other associated pathology. Once the labral pathology was identified [Figure 1], a second low anterior portal was created with an 8.25 mm cannula to help complete the anterior portion of the repair. The glenoid and labrum were then debrided from anterior to posterior [Figure 1], creating a lightly bleeding surface along the entire labral avulsion, including the 6 o'clock position as viewed from posterior. Next, the camera was placed anterior to view posterior. A 5.0 mm cannula was placed in the viewing portal posteriorly to complete the debridement of the glenoid and labrum.

Bottom Line: Eleven of 12 patients (91.7%) had good or excellent scores.Ten of 12 patients (83.3%) had a feeling of stability in the shoulder.All 12 patients reached were satisfied with the procedure and would undergo surgery again in a similar situation.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, OSU Sports Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA.

ABSTRACT

Introduction: We describe the presentation, exam findings, surgical repair techniques, and short-term outcomes in a series of patients with isolated inferior labral tears.

Materials and methods: A retrospective chart review was performed at a large academic medical center. Isolated inferior labral tears were defined as between the 4 o'clock and 8 o'clock position of the glenoid as determined by direct arthroscopic visualization. Tears that were smaller were also included but were required to cross the 6 o'clock point, having anterior and posterior components. Patients were excluded if they had any other pathology or treatment of the shoulder. 1-year follow-up was required.

Results: Of the 17 patients who met inclusion criteria for review, 12 were available for a minimum 1-year follow-up. Average total follow-up for patients to complete the phone interview/Oxford Shoulder Instability Score (OSIS) was an average of 37.7 months (range: 16-79 months). Postoperatively, all reported symptom improvement or resolution since surgery. The mean preoperative pain on a scale of 0-10 was 6.3 (range: 0-10). Mean postoperative pain on a scale of 0-10 was 2.25 (range: 0-5). Eleven of 12 patients (91.7%) had returned to the level of activity desired. The mean OSIS was 41.4 (median: 43; range: 27-47). Eleven of 12 patients (91.7%) had good or excellent scores. Ten of 12 patients (83.3%) had a feeling of stability in the shoulder. All 12 patients reached were satisfied with the procedure and would undergo surgery again in a similar situation.

Conclusions: We have presented our series of patients with isolated inferior labral injury, and have shown that when surgically treated, outcomes of this uncommon injury are good to excellent and a full return to sports can be expected.

No MeSH data available.


Related in: MedlinePlus