This cadaveric study mapped the gross, histological, and vascular anatomy of the glenoid labrum in 23 fresh-frozen shoulders. It characterized regional differences in labral morphology, attachment, and blood supply around the glenoid rim. The goal was to define what is normal anatomy versus pathology relevant to instability and SLAP lesions.
When you see a mobile, loosely attached superior labrum on arthroscopy, do not call it instability. This study establishes that superior and anterosuperior mobility is normal anatomy. The decision rule the authors offer: detachment below the glenoid mid-point suggests instability, while loose attachment above the mid-point is a normal finding.
The direct insertion of the superior labrum into the biceps tendon is the anatomic foundation for the SLAP lesion. Traction from the long head of biceps during throwing deceleration stresses this junction. The vascular map matters for repair. The anterosuperior labrum is relatively avascular, which the authors suggest may slow healing there even when the rim is abraded to stimulate bleeding.
The practical surgical point: unless the anteroinferior labral and capsular lesions are addressed, any instability repair is likely to fail.
This cadaveric study mapped the gross, histological, and vascular anatomy of the glenoid labrum in 23 fresh-frozen shoulders. It characterized regional differences in labral morphology, attachment, and blood supply around the glenoid rim. The goal was to define what is normal anatomy versus pathology relevant to instability and SLAP lesions.
When you see a mobile, loosely attached superior labrum on arthroscopy, do not call it instability. This study establishes that superior and anterosuperior mobility is normal anatomy. The decision rule the authors offer: detachment below the glenoid mid-point suggests instability, while loose attachment above the mid-point is a normal finding.
The direct insertion of the superior labrum into the biceps tendon is the anatomic foundation for the SLAP lesion. Traction from the long head of biceps during throwing deceleration stresses this junction. The vascular map matters for repair. The anterosuperior labrum is relatively avascular, which the authors suggest may slow healing there even when the rim is abraded to stimulate bleeding.
The practical surgical point: unless the anteroinferior labral and capsular lesions are addressed, any instability repair is likely to fail.