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Die Pathologie des Labrum glenoidale

Pathology of the glenoid labrum

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Abstract

The glenoid labrum is a peripherally elevated part of the glenoid rim that consists mostly of fibrous tissue. It plays an important role in the stabilization of the glenohumeral joint. The normal anatomy of the glenoid labrum varies widely and it is difficult to distinguish between normal conditions and a pathological finding. Good knowledge of the anatomy of the glenoid labrum is essential to judge clinical, radiographic and arthroscopic findings. Use of magnetic resonance arthrography (Arthro-MRI) of the shoulder is the best method to evaluate pathologic conditions of the glenoid labrum. The status of the labrum in anteroinferior, posterior and multidirectional instability of the shoulder will be shown in this article by Arthro-MRI and arthroscopic views.

Zusammenfassung

Das Labrum glenoidale ist sowohl für die Funktion der Schulter als auch für ihre Stabilität von großer Bedeutung. Das Labrum glenoidale gehört zu den statischen Stabilisatoren der Schulter und trägt wesentlich dazu bei, das knöcherne Ungleichgewicht zwischen Humeruskopf und Gelenkpfanne auszugleichen. Um zwischen einem Normalbefund, einer anatomischen Variante und einem pathologischen Befund unterscheiden zu können, ist die Kenntnis der Anatomie des Labrum glenoidales grundlegend. Das periartikuläre Fasersystem, welches das Labrum glenoidale bildet, stabilisiert zum einen das Glenohumeralgelenk, zum anderen bildet es die Verbindung zwischen der Cavitas glenoidalis und der angrenzenden Kapsel, inklusive den glenohumeralen Bändern. Den Goldstandard in der Diagnostik von Verletzungen des Labrum glenoidale stellt die MRT-Untersuchung mit intraartikulärer Kontrastmittelgabe (Arthro-MRT) dar. Die unterschiedlichen Läsionen des Labrum glenoidalis bei anteroinferiorer, posteriorer und multidirektionaler Instabilität sowie bei SLAP-Läsionen werden anhand von Fallbeispielen mit Arthro-MRT Bildern und arthroskopischen Bildern veranschaulicht.

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Literatur

  1. Wilk KE, Arrigo CA,Andrews JR (1997) Current concepts: the stabilizing structures of the glenohumeral joint. J Orthop Sports Phys Ther 25(6):364–379

    PubMed  CAS  Google Scholar 

  2. Saha AK (1971) Dynamic stability of the glenohumeral joint. Acta Orthop Scand 42(6):491–505

    Article  PubMed  CAS  Google Scholar 

  3. Boardman ND, et al. (1996) Tensile properties of the superior glenohumeral and coracohumeral ligaments. J Shoulder Elbow Surg 5(4):249–254

    Article  PubMed  CAS  Google Scholar 

  4. Barthel T, et al. (2003) Anatomy of the glenoid labrum. Orthopade 32(7):578–585

    Article  PubMed  CAS  Google Scholar 

  5. Huber WP, Putz RV (1997) Periarticular fiber system of the shoulder joint. Arthroscopy 13(6):680–691

    Article  PubMed  CAS  Google Scholar 

  6. Lippitt S, Matsen F (1993) Mechanisms of glenohumeral joint stability. Clin Orthop Relat Res 291:20–28

    PubMed  Google Scholar 

  7. Snyder SJ, et al. (1990) SLAP lesions of the shoulder. Arthroscopy 6(4):274–279

    Article  PubMed  CAS  Google Scholar 

  8. Ilahi OA (2004) Anatomical variants in the anterosuperior aspect of the glenoid labrum. J Bone Joint Surg Am 86-A(2):432–433; author reply 433

    PubMed  Google Scholar 

  9. Pfahler M, et al. (2003) Age-related changes of the glenoid labrum in normal shoulders. J Shoulder Elbow Surg 12(1):40–52

    Article  PubMed  CAS  Google Scholar 

  10. Cooper DE, et al. (1992) Anatomy, histology, and vascularity of the glenoid labrum. An anatomical study. J Bone Joint Surg Am 74(1):46–52

    PubMed  CAS  Google Scholar 

  11. Waldt S, et al. (2005) Anterior shoulder instability: accuracy of MR arthrography in the classification of anteroinferior labroligamentous injuries. Radiology 237(2):578–583

    Article  PubMed  Google Scholar 

  12. Robinson G, et al. (2006) Normal anatomy and common labral lesions at MR arthrography of the shoulder. Clin Radiol 61(10):805–821

    Article  PubMed  CAS  Google Scholar 

  13. Flannigan B, et al. (1990) MR arthrography of the shoulder: comparison with conventional MR imaging. AJR Am J Roentgenol 155(4):829–832

    PubMed  CAS  Google Scholar 

  14. Beltran J, et al. (1997) Glenohumeral instability: evaluation with MR arthrography. Radiographics 17(3):657–673

    PubMed  CAS  Google Scholar 

  15. Escobedo EM, et al. (2007) Increased risk of posterior glenoid labrum tears in football players. AJR Am J Roentgenol 188(1):193–197

    Article  PubMed  Google Scholar 

  16. Gohlke F, Hedtmann A (2002) Schulter, In: Wirth CJ (ed) Orthopädie und Orthopädische Chirurgie, Stuttgart, New York: Thieme

  17. Weber BG, Simpson LA, Hardegger F (1984) Rotational humeral osteotomy for recurrent anterior dislocation of the shoulder associated with a large Hill-Sachs lesion. J Bone Joint Surg Am 66(9):1443–1450

    PubMed  CAS  Google Scholar 

  18. Rowe CR, Sakellarides HT (1961) Factors related to recurrences of anterior dislocations of the shoulder. Clin Orthop 20:40–48

    PubMed  CAS  Google Scholar 

  19. Resch H, Wanitschek P, Sperner G (1989) The technic of the Bankart operation, A modified reinsertion technic. Unfallchirurg 92(8):407–413

    PubMed  CAS  Google Scholar 

  20. Scheibel M, et al. (2006) Postoperative subscapularis muscle insufficiency after primary and revision open shoulder stabilization. Am J Sports Med 34(10):1586–1593

    Article  PubMed  Google Scholar 

  21. Scheibel M, et al. (2007) Structural integrity and clinical function of the subscapularis musculotendinous unit after arthroscopic and open shoulder stabilization. Am J Sports Med 35(7):1153–1161

    Article  PubMed  Google Scholar 

  22. Cicak N, et al. (2005) Arthroscopic extracapsular plication to treat multidirectional instability of the shoulder. Arthroscopy 21(10):1278

    Article  PubMed  Google Scholar 

  23. Bradley JP, et al. (2006) Arthroscopic capsulolabral reconstruction for posterior instability of the shoulder: a prospective study of 100 shoulders. Am J Sports Med 34(7):1061–1071

    Article  PubMed  Google Scholar 

  24. Carreira DS, et al. (2006) A prospective outcome evaluation of arthroscopic Bankart repairs: minimum 2-year follow-up. Am J Sports Med 34(5):771–777

    Article  PubMed  Google Scholar 

  25. Kim SH, et al. (2004) Arthroscopic capsulolabroplasty for posteroinferior multidirectional instability of the shoulder. Am J Sports Med 32(3):594–607

    Article  PubMed  Google Scholar 

  26. Tischer T, Vogt S, Imhoff AB (2007) Arthroscopic stabilization of the shoulder with suture anchors with special reference to the deep anterior-inferior portal (5, 30 o'clock). Oper Orthop Traumatol 19(2):133–154

    Article  PubMed  Google Scholar 

  27. De Simoni C, Imhoff AB (2000) Ein neuer inferiorer (5:30-Uhr-) Zugang für die arthroskopische Reparation des Bankart-Schadens. Arthroskopie 13:217–219

    Article  Google Scholar 

  28. Jerosch J, Castro WH (1990) Shoulder instability in Ehlers-Danlos syndrome. An indication for surgical treatment? Acta Orthop Belg 56(2):451–453

    PubMed  CAS  Google Scholar 

  29. Beighton PGR, Bird H (1984) Bandlaxität: Messmethoden und Epidemiologie. Orthopäde 13:19–24

    PubMed  CAS  Google Scholar 

  30. Maffet MW, Gartsman GM, Moseley B (1995) Superior labrum-biceps tendon complex lesions of the shoulder. Am J Sports Med 23(1):93–98

    Article  PubMed  CAS  Google Scholar 

  31. Imhoff AB, et al. (2000) Superior labrum pathology in the athlete. Orthopade 29(10):917–927

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Abteilung und Poliklinik für Sportorthopädie, Klinikum rechts der Isar, Connollystr. 32, 80809, München, Germany

    Jochen Paul,  Philip B. Schöttle &  Andreas B. Imhoff

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  1. Jochen Paul
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  2. Philip B. Schöttle
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  3. Andreas B. Imhoff
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Correspondence to Andreas B. Imhoff.

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Paul, J., Schöttle, P.B. & Imhoff, A.B. Die Pathologie des Labrum glenoidale. Obere Extremität 2, 143–149 (2007). https://doi.org/10.1007/s11678-007-0055-0

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  • DOI: https://doi.org/10.1007/s11678-007-0055-0

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