Current Non-operative Management of Shoulder Pathologies: A Narrative Review.

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Abstract

Conflict of interest statement: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. 4. Orthop Traumatol Surg Res. 2015 Feb;101(1 Suppl):S19-24. doi: 10.1016/j.otsr.2014.06.028. Epub 2015 Jan 14. Glenoid labrum pathology. Clavert P(1). Author information: (1)Service de chirurgie du membre supérieur, hôpitaux universitaires-CCOM, 10, avenue Baumann, 67400 Illkirch, France. Electronic address: philippe.clavert@chru-strasbourg.fr. The glenoid labrum is the fibrocartilage of the shoulder joint, anchoring the joint capsule and shoulder ligaments. Morphology varies regionally, especially in the superior and anterior region; these variants can sometimes be confused with pathological aspects. The labrum is often involved in shoulder pathology, by single trauma or, more often, repeated microtrauma. It seems logical to classify and to describe tears according to two criteria: the sector involved, and associated pain or instability. In the superior labrum, SLAP lesions are the most frequent. These combine labral lesion and lesion of the proximal insertion of the long head of the biceps brachii tendon. The most frequent form is SLAP II. They may be associated with instability or not. In the antero-inferior and postero-inferior labrum, lesions are mainly due to instability, particularly Bankart lesions (capsulolabral avulsion) anteriorly and Kim's lesion posteriorly. Circumferential labral lesions may be found in unstable shoulder. Finally, postero-superior lesions involve Walch's internal impingement: repeated contact between the deep surface of the cuff and the labrum, which takes on a degenerative aspect, with a kissing lesion of the cuff. There is no general rule for management: some labral lesions are resected and others fixed. The cause (which is usually shoulder instability), however, needs to be assessed and treated. Copyright © 2014 Elsevier Masson SAS. All rights reserved. DOI: 10.1016/j.otsr.2014.06.028