Habermeyer, J Shoulder Elbow Surg 1999 - Evolution of Lesions of the Labrum-Ligament Complex in Posttraumatic Anterior Shoulder Instability: A Prospective Study
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Evolution of Lesions of the Labrum-Ligament Complex in Posttraumatic Anterior Shoulder Instability: A Prospective Study
Habermeyer, Rickert, et al.·J Shoulder Elbow Surg·1999·189 citations
Habermeyer and colleagues examined unstable shoulders arthroscopically after different numbers of recurrences to trace how the labrum‑ligament lesion evolves in posttraumatic anterior instability.
Prospective single‑surgeon series of 91 patients, October 1992 to November 1993, grouped by number of instability events.
Key Findings
Lesions accumulated with recurrence. The authors proposed four stages: labral detachment, then ligament detachment, then tissue damage, then destruction of the labrum‑ligament complex.
Labral detachment came first: it was present in 8 of 9 first‑time dislocations and in all 12 shoulders with one or two recurrences.
Detachment of the inferior glenohumeral ligament from the glenoid rose from 1 of 12 shoulders after one or two recurrences to 15 of 23 after three to five.
In the authors' opinion, the third recurrence is the point of no return, after which the tissues progressively and irreversibly lose their mechanical properties.
Each group was a different set of patients, so the progression is inferred rather than observed. The authors state that no treatment implications can be drawn, because outcomes were not studied.
Authors' conclusion
This study reveals that recurrences progressively damage stabilizing structures.
Habermeyer and colleagues examined unstable shoulders arthroscopically after different numbers of recurrences to trace how the labrum‑ligament lesion evolves in posttraumatic anterior instability.
Prospective single‑surgeon series of 91 patients, October 1992 to November 1993, grouped by number of instability events.
Key Findings
Lesions accumulated with recurrence. The authors proposed four stages: labral detachment, then ligament detachment, then tissue damage, then destruction of the labrum‑ligament complex.
Labral detachment came first: it was present in 8 of 9 first‑time dislocations and in all 12 shoulders with one or two recurrences.
Detachment of the inferior glenohumeral ligament from the glenoid rose from 1 of 12 shoulders after one or two recurrences to 15 of 23 after three to five.
In the authors' opinion, the third recurrence is the point of no return, after which the tissues progressively and irreversibly lose their mechanical properties.
Each group was a different set of patients, so the progression is inferred rather than observed. The authors state that no treatment implications can be drawn, because outcomes were not studied.
Authors' conclusion
This study reveals that recurrences progressively damage stabilizing structures.