Advances in surgical management of superior labrum, anterior-to-posterior lesions

Abstract

Superior labrum, anterior-to-posterior lesions of the shoulder have become a well-recognized entity over the past several years. The expanded role of arthroscopy in the diagnosis and management of shoulder disorders in general has improved our understanding of pathologic conditions involving the glenoid labrum. From an anatomic perspective, superior labrum, anterior-to-posterior tears involve a disruption of the superior labrum and biceps anchor. This injury commonly results in shoulder pain, often with associated clicking or popping, and a resultant loss of shoulder function. Disruption of the biceps anchor may also contribute to subtle instability of the glenohumeral joint. The prevalence of superior labrum, anterior-to-posterior tears, especially in throwing athletes, has been documented. However, issues that continue to evolve include the precise mechanism of injury, the biomechanical role of the biceps anchor, the most effective means of diagnosis, and the optimal surgical management. This article reviews current understanding of superior labrum, anterior-to-posterior lesions with an emphasis on diagnostic methods and recent advances in surgical repair. The most relevant literature on this topic is highlighted.