Department of Orthopaedic Surgery, Burke & Bradley Orthopedics, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Department of Orthopaedic Surgery, Orthopaedic Shoulder, Hip, Knee, and Sports Medicine of Louisiana State University Health Shreveport, Shreveport, Louisiana, USA.
Am J Sports Med. 2024 Jul;52(8):2063-2070. doi: 10.1177/03635465241253835. Epub 2024 Jun 3.
Anterior shoulder labral tearing has historically been considered the most common location of shoulder labral pathology. Recently, smaller studies have reported that posterior labral involvement may be more common than previously recognized.
To examine the location of surgically repaired labral tears by a single surgeon over a consecutive 23-year period.
Case series; Level of evidence, 4.
A total of 1763 consecutive patients who underwent arthroscopic or open shoulder labral repair by a single seniorsports medicine fellowship-trained orthopaedic surgeon between April 2000 and April 2023 were retrospectively reviewed. Current Procedural Terminology codes were used to identify patients, which included 29806, 29807, 29822, and 29823. Exclusion criteria included isolated shoulder manipulation or glenohumeral joint or labral debridement that did not include repair. Intraoperative glenoid labral tears observed were categorized into 7 broad categories: (1) anterior labral tears, (2) posterior labral tears, (3) superior labral anterior posterior (SLAP) type II tears (A, B, or C), (4) SLAP type V tears, (5) SLAP type VIII tears, or (6) circumferential labral tears (combined SLAP, anterior, and posterior labral tear). Shoulders diagnosed with multiple tear patterns (ie, anterior and posterior) were also noted.
During the 23-year period, 1763 patients underwent arthroscopic or open labral repair; they included 1295 male and 468 female patients, ranging in age from 12 to 70 years, with a mean age of 23.2 years and median age of 19 years. Overall, 28.4% of tears involved the anterior labrum, 64.9% involved the posterior labrum, and 59.6% involved the superior labrum. Regarding isolated tears, 9.3% were isolated anterior labral tears, 19.7% were isolated posterior labral tears, 11.5% involved the anterior and posterior labrum, 22.2% were isolated superior (SLAP type II-IV) tears, 3.63% were isolated SLAP type V tears, 29.8% were isolated SLAP type VIII tears, and 4.1% were circumferential tears.
Posterior shoulder labral tearing was more common than anterior tearing in a large consecutive series of 1763 patients who underwent surgical repair. This highlights the importance of posterior labral pathology, which sometimes may be overlooked because of more vague complaints, with pain and loss of function being the most common.
肩部盂唇撕裂以往被认为是最常见的肩部盂唇病变部位。最近，一些较小的研究报告称，后盂唇病变可能比以前认识到的更为常见。
通过一位外科医生连续 23 年的研究，检查手术修复的盂唇撕裂的位置。
病例系列；证据等级，4 级。
回顾性分析了 2000 年 4 月至 2023 年 4 月期间由一位资深运动医学 fellowship 培训的骨科医生进行的 1763 例连续关节镜或开放性肩盂唇修复患者的资料。使用当前的程序术语 (Current Procedural Terminology，CPT) 代码识别患者，包括 29806、29807、29822 和 29823。排除标准包括单独进行的肩部手法或盂肱关节或盂唇清创术，而不包括修复。术中观察到的关节盂唇撕裂分为 7 个广泛的类别：(1) 前盂唇撕裂，(2) 后盂唇撕裂，(3) 上盂唇前后 (SLAP) Ⅱ型撕裂 (A、B 或 C)，(4) SLAP Ⅴ型撕裂，(5) SLAP Ⅷ型撕裂，或 (6) 环状盂唇撕裂（结合 SLAP、前盂唇和后盂唇撕裂）。还记录了诊断为多种撕裂模式（即前盂唇和后盂唇撕裂）的肩部。
在 23 年期间，1763 例患者接受了关节镜或开放性盂唇修复术；其中 1295 例为男性，468 例为女性，年龄 12 至 70 岁，平均年龄 23.2 岁，中位年龄 19 岁。总体而言，28.4%的撕裂涉及前盂唇，64.9%涉及后盂唇，59.6%涉及上盂唇。关于孤立性撕裂，9.3%为孤立性前盂唇撕裂，19.7%为孤立性后盂唇撕裂，11.5%累及前盂唇和后盂唇，22.2%为孤立性上盂唇（SLAP Ⅱ-Ⅳ型）撕裂，3.63%为孤立性 SLAP Ⅴ型撕裂，29.8%为孤立性 SLAP Ⅷ型撕裂，4.1%为环状撕裂。
在 1763 例接受手术修复的连续患者中，后肩盂唇撕裂比前肩盂唇撕裂更为常见。这突出了后盂唇病变的重要性，由于更模糊的症状，有时可能会被忽视，疼痛和功能丧失是最常见的。
