Kim et al. describe a new arthroscopic entity — an incomplete, concealed avulsion of the posteroinferior labrum in patients presenting with posterior or multidirectional posteroinferior shoulder instability. The study defines its appearance, MRI correlates, and arthroscopic treatment, asking whether identifying and repairing this lesion improves stability outcomes.
When scoping a shoulder for posterior instability, don't trust your eyes — always probe the posteroinferior labrum from the 6- to 9-o'clock position, because Kim's lesion looks intact superficially and will be missed without tactile assessment.
If you find fluctuation or a loose deep attachment, you must incise the superficial layer, convert it to a full-thickness tear, and repair it with the posterior band of the IGHL incorporated in the first anchor; skipping this step and doing capsular plication alone risks persistent instability.
Kim et al. describe a new arthroscopic entity — an incomplete, concealed avulsion of the posteroinferior labrum in patients presenting with posterior or multidirectional posteroinferior shoulder instability. The study defines its appearance, MRI correlates, and arthroscopic treatment, asking whether identifying and repairing this lesion improves stability outcomes.
When scoping a shoulder for posterior instability, don't trust your eyes — always probe the posteroinferior labrum from the 6- to 9-o'clock position, because Kim's lesion looks intact superficially and will be missed without tactile assessment.
If you find fluctuation or a loose deep attachment, you must incise the superficial layer, convert it to a full-thickness tear, and repair it with the posterior band of the IGHL incorporated in the first anchor; skipping this step and doing capsular plication alone risks persistent instability.