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. 5. Orthopade. 2000 Oct;29(10):917-27. Obere Labrumpathologie beim Sportler. [Article in German] Imhoff AB(1), Agneskirchner JD, Konig U, Temme C, Ottl G, McFarland EG. Author information: (1)Abteilung fur Sportorthopadie, Technische Universitat|| Munchen (TUM), Connollystrasse 32, 80809, Munchen.|| A.lmhoff@lrz.tum.de Since their first description several years ago, superior||| glenoid labral lesions have increasingly been blamed for shoulder problems||| associated with sports. Originally merely describing arthroscopically visible||| upper labral/biceps abnormalities, the current understanding is that often||| clinical problems such as impingement pain or even rotator cuff disease can be||| secondary to these lesions, especially in overhead athletes. Impingement in||| these cases is caused by superior shoulder instability originating from an||| unstable biceps insertion that is present for example in SLAP (superior labrum||| from anterior to posterior) lesions. Additional problems such as internal or||| posterosuperior impingement that are often found simultaneously in these||| patients are pathomorphologically located in the same anatomical region and||| therefore make exact diagnosis and thus treatment more complex. Magnetic||| resonance imaging with intra-articular contrast enhancement and particularly||| arthroscopy are the primary tools for exact diagnosis and classification of||| superior labral/biceps pathology. Therapeutically, lesions with unstable biceps||| origin (SLAP types 2 and 4) require operative refixation, as we have seen in||| our 50 cases in the last 4 years, in order to reestablish the stabilising||| effect of the biceps tendon for the shoulder joint. The arthroscopic technique||| for repair of these lesions using different devices of implantable suture||| anchors is presented. Long-term pain-free shoulder function in competitive||| athletes, throwers in particular, thus requires anatomical reconstruction of||| the originally unstable biceps, which is the causal therapy for these||| lesions.