this is where the top of the labrum is pulled off the top of the Glenoid bone by the Biceps tendon during
B) Bankart Lesion
this “stretching” of the ligaments is most often a combination of genetics and overuse. The tissue making up the ligaments (Collagen) is more elastic in some patients and repetitive overhead activities can stress it enough to elongate it, causing capsular laxity. The result can be Multidirectional Instability (MDI). This disorder is characterized by a shoulder that easily dislocates and reduces in multiple directions. It is usually seen in teenage female athletes (Estrogen has an effect on Collagen which allows it to become lax).
these labrum and ligament injuries DO NOT HEAL and therefore require SURGERY
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A) SLAP REPAIR - this is an arthroscopic surgery of the shoulder that is performed on an outpatient basis. Three or four tiny
B) BANKART REPAIR - this procedure is the same as SLAP REPAIR except the part of the labrum that is repaired is at the bottom, and
C) CAPSULAR PLICATION - Capsular laxity is best treated with plication or pleating (as you do with curtains) of the ligaments. 10 mm
1. Anatomy and Function -
The LABRUM is a fibrocartilage ring around the bony cup (Glenoid) of the shoulder. This firm ring of soft tissue is attached to the rim of this shallow saucer-shaped bone, deepening the socket and assisting with joint stability. At the top of the labrum (12 o'clock position), the Long Head of the Biceps tendon finds its origin. The GLENOHUMERAL LIGAMENTS (capsule) which tether the Humeral Head to the Glenoid, are the keys to stability of the joint during shoulder motion. The main one is the Inferior Glenohumeral Ligament, which attaches the bottom of the Glenoid to the bottom of the Humeral Head…tightening with rotation of the arm and thereby The GLENOHUMERAL LIGAMENT (capsule) which tether the Humeral Head to the Glenoid, are the keys to stability of the joint during shoulder motion. The main one is the Inferior Glenohumeral Ligament, which attaches the bottom of the Glenoid to the bottom of the Humeral Head…tightening with rotation of the arm and thereby Stabilizing the shoulder during strenuous activity
A) Slap Tear
- the glenoid labrum can be torn in various locations and patterns:
this tear occurs during traumatic shoulder (glenohumeral) Dislocation. When the humeral head is forced out the front of the glenoid, the anterior labrum tears (Anterior Bankart). Much less often, the humeral head is forced out the back of the Glenoid and a Posterior Bankart lesion occurs. These tears are located along the bottom half of the glenoid rim and thereby cause laxity of the key Inferior Glenohumeral Ligament which attaches there. The result is Recurrent Dislocations or Instability of the glenohumeral joint.
C) Capsular Laxity