Advertisement

Arthroscopic debridement of glenoid labral tears in athletes

  • Robert J. Tomlinson Jr
    Correspondence
    Address correspondence and reprint requests to Robert J. Tomlinson, M.D., Arnold Orthopaedic Associates, 1794 E. Joyce Blvd., Suite 3, Fayetteville, AR 72703, U.S.A.
    Affiliations
    Southern California Orthopedic Institute, Van Nuys, California, U.S.A.

    Kerlan Jobe Orthopaedic Clinic, Inglewood, California, U.S.A.
    Search for articles by this author
  • Ronald E. Glousman
    Affiliations
    Southern California Orthopedic Institute, Van Nuys, California, U.S.A.

    Kerlan Jobe Orthopaedic Clinic, Inglewood, California, U.S.A.
    Search for articles by this author
      This paper is only available as a PDF. To read, Please Download here.

      Abstract

      This is a retrospective study of 46 patients who underwent arthroscopic glenoid labral debridement from June 1988 to June 1990. All patients complained of pain in the involved shoulder and all were active in sports involving overhead use of the shoulder, including 30 baseball players (16 professional, 14 collegiate/high school). The average age was 22 years (range 16 to 45) and the average follow-up was 2.7 years (range 18 to 50 months). At operation, 35 patients had posterior glenoid lesions, 9 had anterior-superior lesions, and 2 had anterior-inferior lesions. The posterior lesions were further divided into those that involved a horizontal flap tear (n = 19), and those that involved fraying (n = 16). Overall, at an average of 31 months follow-up, 54% (25 of 46) of patients had good to excellent results. Professional baseball players had a statistically significant enhanced outcome with 75% (12 of 16) good-excellent compared with the remaining nonprofessional group, with 43% (13 of 30) good-excellent results. Outcome did not correlate with shoulder laxity, labral lesion location, mechanism of injury, or the presence of a rotator cuff lesion. Conclusions: Arthroscopic debridement of glenoid labral lesions does not yield consistent long-term results. Aggressive, supervised physical therapy in highly motivated individuals may be the most important factors in influencing outcome in patients having arthroscopic labral debridement in the absence of overt shoulder instability.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Arthroscopy
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Perthes G
        Uber Operationen Bei Habitueller Schulterluxation.
        Deutsche Z Chir. 1906; 85: 199-227
        • Bankart AS
        Recurrent or habitual dislocation of the shoulder joint.
        BMJ. 1923; 2: 1132
        • Altchek DW
        • Warren RF
        • Wickiewicz TL
        • Ortiz G
        Arthroscopic labral debridement.
        in: A three-year follow-up study. Ed 2. Am J Sports Med. 20. 1992: 702-706
        • Andrews JR
        • Carson WG
        The arthroscopic treatment of glenoid labrum tears in the throwing athlete.
        Orthop Trans. 1984; 8 (abstr): 44
        • Cordasco FA
        • Steinman S
        • Flatlow EL
        • Bigliani LU
        Arthroscopic treatment of glenoid labral tears.
        Am J Sports Med. 1993; 21: 425-431
        • Glasgow SG
        • Bruce RA
        • Yacobucci GN
        • Torg JS
        Arthroscopic resection of glenoid labral tears in the athlete.
        Arthroscopy. 1992; 8: 48-54
        • Jobe FW
        • Kvitne RS
        • Giangarra CE
        Shoulder pain in the overhead or throwing athlete: The relationship of anterior instability and rotator cuff impingement.
        Orthop Rev. 1989; 18: 963-967
        • Gerber C
        • Ganz R
        Clinical assessment of instability of the shoulder.
        J Bone Joint Surg Br. 1984; 66: 551-556
        • Cooper DE
        • Arnoczky SP
        • O'Brien SJ
        • Warren RF
        • DiCarlo E
        • Allen AA
        Anatomy, histology, and vascularity of the glenoid labrum: An anatomic study.
        J Bone Joint Surg Am. 1992; 74: 46-52
        • Coudane H
        The classification of lesions of the glenoid labrum.
        in: A review of 92 arthroscopies of the shoulder. Ed 2. Orthop Trans. 13. 1989: 698 (abstr)
        • Snyder SJ
        • Karzel RP
        • Del Pizzo W
        • Ferkel RD
        • Friedman MJ
        SLAP lesions of the shoulder.
        Arthroscopy. 1990; 6: 274-279
        • Pappas AM
        • Goss TP
        • Kleiman PK
        Symptomatic shoulder instability due to lesions of the glenoid labrum.
        Am J Sports Med. 1983; 11: 279-288
        • DePuy J
        • Steiner ME
        Isolated shoulder labral tears—Treatment and correlation with labral anatomy.
        Orthop Trans. 1990; 14 (abstr): 244
        • Jobe FW
        • Bradley JP
        • Pink M
        Impingement syndrome in overhead athletes: Part I. Surgical Rounds for Orthopedics.
        in: 1990; Aug: 19-22
        • Matsen FA
        • Thomas SC
        • Rockwood CA
        Anterior glenohumeral instability.
        in: Rockwood Jr, CA Matsen FA The shoulder. Saunders, Philadelphia1990: 550
        • Jobe CM
        Evidence linking posterior superior labral impingement and shoulder instability.
        in: Presented at the American Shoulder and Elbow Surgeons Meeting, Seattle, WASeptember 1991
        • Kvitne RS
        • Jobe FW
        The diagnosis and treatment of anterior instability in the throwing athlete.
        Clin Orthop. 1993; 291
        • Walch G
        • Beaufils P
        • Wakim E
        Le conflit glenoidier posterosuperieur: Un autre conflit de l'epaule.
        Rev Chir Orthop. 1991; 77: 571-574
        • Nixon JE
        • DiStefano V
        Rupture of the rotator cuff.
        Orthop Clin North Am. 1975; 6: 423-447
        • Andrews JR
        • Carson WG
        • McLeod WD
        Glenoid labrum tears related to the long head of the biceps.
        Am J Sports Med. 1985; 13: 337-341
        • DiGiovine N
        • Jobe FW
        • Pink M
        • Perry J
        An EMG analysis of the upper extremity in pitching.
        J Shoulder Elbow Surg. 1992; 1: 15-25
        • Rodosky MW
        • Rudert JM
        • Harner CH
        • Luo L
        • Fu FH
        The role of the biceps-superior glenoid labrum complex in anterior stability of the shoulder.
        Arthroscopy. 1990; 6 (abstr): 160-161
        • Matsen III, FA
        • Arntz CT
        Rotator cuff tendon failure.
        in: Rockwood Jr, CA Matsen III, FA The shoulder. Saunders, Philadelphia1990: 647-676