Kibler W Ben, Grantham William J, Pike John Stuart Mattison, Sciascia Aaron D
Shoulder Center of Kentucky, Lexington Clinic, Lexington, Kentucky, U.S.A.
Medical University of South Carolina, Charleston, South Carolina, U.S.A.
Arthrosc Sports Med Rehabil. 2021 Dec 24;4(2):e535-e544. doi: 10.1016/j.asmr.2021.11.014. eCollection 2022 Apr.
To categorize arthroscopically observed labral injuries to include location on the glenoid and frequency of the injuries in each location.
Patients undergoing arthroscopic labral surgery between January 2018 and June 2020 were reviewed. Inclusion criteria for labral injury were consistently applied and included history, clinical examination and imaging findings, and failure of rehabilitation. Exclusion criteria included arthritis, adhesive capsulitis, and previous surgery. Injury locations were categorized into superior, anterior, and/or posterior areas on the glenoid and as isolated in one area or combined in more than one area. Injury patterns also were evaluated. Interrater and intrarater agreement was assessed between 2 raters for injury location and tear pattern for 22 randomly assigned cases.
In total, 167 cases met the inclusion criteria. Injuries were found in all areas. Combined injuries were found almost twice as often as isolated injuries (63.5% vs 37.5%). Isolated posterior injuries had the greatest frequency of all specific injury types (26.3%). Isolated superior injuries (SLAP 2-4) had a frequency of 7.2%. Tear patterns included peel back, separation/split, insubstance injury, peripheral rim flattening, and extension into the posterior inferior glenohumeral ligament. Interrater was excellent for all tear locations (intraclass correlation coefficient ≥0.85) whereas intrarater agreement was good to excellent (intraclass correlation coefficient ≥0.63).
Labral injuries that are associated with clinical symptoms can occur as isolated or combined types in the superior, anterior, and posterior glenoid areas and can display multiple injury patterns. Combined types of injuries are almost twice as common as those that are isolated in one area. Posterior injuries, isolated or combined, are frequent but superior injuries are less common.
Level IV, therapeutic case series.
对关节镜观察到的盂唇损伤进行分类，包括损伤在肩胛盂上的位置以及每个位置损伤的频率。
回顾2018年1月至2020年6月期间接受关节镜盂唇手术的患者。始终应用盂唇损伤的纳入标准，包括病史、临床检查和影像学检查结果以及康复失败。排除标准包括关节炎、粘连性关节囊炎和既往手术史。损伤位置分为肩胛盂的上、前和/或后区域，以及孤立于一个区域或合并在多个区域。还评估了损伤模式。对22例随机分配病例的损伤位置和撕裂模式，在两名评估者之间评估了评估者间和评估者内的一致性。
总共167例符合纳入标准。所有区域均发现损伤。合并损伤的发生率几乎是孤立损伤的两倍（63.5%对37.5%）。孤立的后部损伤在所有特定损伤类型中发生率最高（26.3%）。孤立的上部损伤（SLAP 2 - 4）发生率为7.2%。撕裂模式包括剥离、分离/裂开、实质内损伤、周边边缘变平以及延伸至后下盂肱韧带。评估者间在所有撕裂位置的一致性都非常好（组内相关系数≥0.85），而评估者内一致性为良好至非常好（组内相关系数≥0.63）。
与临床症状相关的盂唇损伤可以上部、前部和后部肩胛盂区域的孤立或合并类型出现，并可表现出多种损伤模式。合并损伤类型几乎是孤立于一个区域的损伤类型的两倍。后部损伤，无论是孤立的还是合并的，都很常见，但上部损伤较少见。
IV级，治疗性病例系列。
