Recurrent Shoulder Dislocation Research Articles

New concepts of radiologic preoperative evaluation of anterior shoulder instability: on-track and off-track lesions.

The shoulder is the most frequently dislocated joint in the body due to a larger range of motion and a small area of articulation between the humeral and glenoid surfaces. Traumatic shoulder dislocations, especially those associated with injury to the labroligamentous or bony stabilizers of the joint, lead to further reduction of articular surface contact with resultant glenohumeral instability and recurrent shoulder dislocations. Imaging plays an increasingly important role in the preoperative evaluation of patients with traumatic shoulder instability by evaluating glenohumeral bone loss (uni- or bipolar), assessing soft tissue injuries and identifying patients at risk of postoperative recurrence. Quantification of bone loss is key to differentiate engaging vs. non-engaging Hill-Sachs lesions, while newer concepts of "on-track" vs. "off-track" lesions are being discussed that can determine the required surgical approaches. In this article, we review the preoperative imaging approaches, traditional treatments, outline the bone loss measurement strategies and review these new tracking concepts with relevant case examples.

Five-year prevalence of recurrent shoulder dislocation in the entire Polish population.

The aim of this study was to evaluate five-year prevalence of recurrent shoulder dislocation in the entire Polish population. The study involved the entire Polish population between 01 January 2010 and 31 December 2014. Demographic data were retrieved from the Central Statistical Office of Poland. Data on the number of shoulder joint dislocations were retrieved from the database of the National Health Fund. We identified 32,253 Polish residents with shoulder instability. About 0.1% of Polish residents suffered from recurrent shoulder dislocation. Males suffered almost two times more often than females (66% and 34%, respectively), and male gender was recognized as a risk factor of instability (OR = 2.07, p <10-10). Females in their eighth decade of life had the highest risk of recurrent shoulder dislocation (OR = 3.33, p <10-10). In males the highest risk of recurrences was noted for the third decade of life (OR = 1.78, p <10-10). The period prevalence rate of recurrent shoulder dislocation in Poland is 83.7 per 100,000 persons per five years. The rate of recurrent shoulder dislocation for the general Polish population is 0.1%. Males suffered from recurrent shoulder dislocation almost twice as frequently as females (OR = 2.07).

Individualized coracoid osteotomy and 3D congruent arc reconstruction of glenoid for the treatment of recurrent anterior shoulder dislocation

BackgroundThe present study investigated individualized coracoid osteotomy for 3D congruent arc glenoid reconstruction and evaluated the clinical outcomes in recurrent anterior shoulder dislocation.MethodsFrom January 2005 to July 2015, 78 patients with glenoid defect underwent coracoid and conjoint tendon transposition. The patients were divided into the individualized group (n = 34) and the non-individualized group (n = 44). All patients had CT data to reconstruct the shoulder model using Mimics software. In the individualized group, the individual coracoid osteotomy and bone fixation position parameters were measured from preoperative planification through simulating a 3D congruent arc glenoid reconstruction model. The non-individualized group underwent classic Bristow-Latarjet (B-L) procedure. The postoperative evaluation parameters included 3D congruent arc index, coracoid bone position, shoulder osteoarthritis index (Samilson-Prieto) and shoulder function score (Rowe, Constant-Murley score).ResultsThe mean follow-up time was 51.0 months (ranging from 24 to 146). The individualized group got 3D congruent arc reconstruction of the glenoid by postoperative CT scanning. Bone position was more precise in the individual group than that in the B-L group. There was a lower incidence of shoulder osteoarthritis (Samilson-Prieto) in the individual group compared with that in the B-L group: 0 vs 13.6% (mild 6/44, P = 0.027), respectively. No significant difference was observed between the individual and B-L groups in rate of re-dislocation: 0 vs 4.5% (2/44, P = 0.315), respectively. The postoperative Rowe and Constant score was significantly improved but was not significantly different between the two groups.ConclusionThe individual procedure achieved 3D congruent arc glenoid reconstruction. The clinical effects in patients with medium glenoid defect were good, especially the low incidence of shoulder osteoarthritis in middle-term follow-up.

Intra-articular Lesions and Clinical Outcomes in Traumatic Anterior Shoulder Dislocation Associated with Greater Tuberosity Fracture of the Humerus

BACKGROUND: This study investigated and evaluated the clinical outcomes of intra-articular lesions of traumatic anterior shoulder dislocation (TASD) associated with greater tuberosity (GT) fracture of the humerus.METHODS: Subjects included 20 patients who were surgically or non-surgically treated for GT fracture of the humeurs with TASD, and followed-up for at least 2 years. The mean follow-up period was 54.1 months (range, 24?105 months). Of the 20 patients, 12 were treated surgically. Intra-articular lesions were identified randomly on magnetic resonance imaging scans (repeated thrice) by experienced radiologists and orthopedic surgeons. The accompanying intra-articular lesions were left untreated. Clinical outcomes were evaluated by Simple Shoulder Test (SST) and Western Ontario Shoulder Instability index (WOSI) at the last follow-up.RESULTS: Intra-articular lesions were identified in 19 patients: 7 Bankart lesions, 15 humeral avulsion of the glenohumeral ligament lesions, 3 glenoid avulsion of the glenohumeral ligament lesion, and 6 inferior capsular tears. Two or more intra-articular lesions were identified in 6 patients. The mean SST score was 10.9 and the mean WOSI score was 449.3 at the last follow-up.CONCLUSIONS: For GT fracture of the humerus with TASD, a high frequency of diverse intra-articular lesions was identified. There were no incidence of recurrent shoulder dislocations, and good clinical outcomes were obtained without treatment of the intra-articular lesions. We thereby comprehend that although intra-articular lesions may occur in TASD associated with GT fracture of the humeurs, merely treating the GT fracture of the humerus is sufficient.

Multidetector CT arthrography in shoulder instability and its comparison with MR arthrography and arthroscopy

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Purpose of this study was to compare diagnostic effectiveness of MDCT arthrography (MDCTA) in shoulder instability and pain in throwing and its comparison to MR arthrography (MRA) and arthroscopy taking arthroscopy as gold standard.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; 20 patients with history of recurrent shoulder dislocation in activity were included in this study. After detailed clinical examination, each patient underwent MDCT-MR arthrography in one sitting followed by diagnostic arthroscopy within 6 weeks. Results were compared with the help of statistician.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; At arthroscopy, 10 Bankart’s lesions, 7 Hill Sachs lesion, 6 SLAP lesion, 1 ALPSA, 1 capsular laxity, 1 partial subscapularis tear and 1 supraspinatus fraying were visualized in 20 shoulders. For Bankart’s lesion MDCT has sensitivity 80%, specificity 100%, positive predictive value (PPV) 100% and negative predictive value (NPV) 83.3%. MRA has sensitivity of 90%, specificity 100%, PPV 100% and NPV 90.9%. For SLAP lesions sensitivity, specificity, PPV and NPV for MDCTA and MRA are 88.3%, 100%, 100%, 93.3%. For Hill-Sachs lesion; sensitivity, specificity, PPV and NPV for MDCTA are all 100% and for MRA they are 85.7%, 100%, 100%, 92.8% respectively. For ALPSA; sensitivity is 100%, specificity is 95%, PPV is 50% and NPV is 100% both for MDCTA and MRA. К value for MRA is 0.60 and for CTA is 0.55 suggesting moderate agreement.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Considering availability, cost, time consumption, superior detection of bony lesions and comparable detection of soft tissue lesions; MDCTA can be used as single investigation of choice in shoulder instability pain.&lt;/p&gt;

The Mini-Open Modified Bristow-Latarjet Procedure for Anterior Shoulder Instability: A 15-Year Study on the Results of 90 Cases

The described procedure is a reproducible and effective technique used to restore joint stability in patients who have incurred anterior recurrent shoulder dislocation. This study presents the middle time results of Modified Bristow–Latarjet consisting of the association of 2 procedures, the congruent glenoid reconstruction with two headless screws fixtion of the standing coracoid and the rotator interval approach ensuring the intactness of subscapularis muscle in the treatment of traumatic anterior shoulder instability. Ninety patients were enrolled in this retrospective case-series study with 2 to 15 years’ follow-up. Preoperatively and postoperatively all patients underwent a computed tomography scan to assess the percentage of glenoid bone loss and the glenoid cavity reconstruction respectively. The rate of recurrent of shoulder instability, Glenohumeral osteoarthritis,bone-healing, bone position and loss of external motion was evaluated. Rowe, ASES (American-Shoulder-Elbow-Surgeons), Constant-Murley, and DASH scores, were used to assess the shoulder function. The mean length of follow-up was 5.6 years (range, 2-15 years). None patients had shoulder redislocation and none reported shoulder indisability. All patients get bone-union in 6 months. The arthropathy of the shoulder, 82(92%)were classified as normal, 6(6%) as mild, 2(2%)as moderate, and none as severe according to Samilson-Prieto classification. The mean loss of external rotation was 11.6°(95%CI, 9.9-13.2) with the arm at the side of the body, and the mean deficit was 12.4°(95%CI, 10.8-14.0) with the arm on abduction 90°. The Rowe, ASES, Constant-Murley and DASH scores showed significant improvements(p<0.001): The Rowe score increased from 45.6 to 92.6, the ASES score increased from 62.0 to 93.9, the Constant-Murley score increase from 58.2 to 90.8,and the DASH score deceased from 15.9 to 5.0. The described procedure is a reproducible and effective technique used to restore joint stability in patients who have incurred anterior recurrent shoulder dislocation.

Arthroscopic Bone Grafting of the Humeral Head for Treatment of a Deep Hill-Sachs Lesion

Recurrent anterior shoulder dislocation often leads to the presence of a Hill-Sachs lesion. A large Hill-Sachs lesion compromises shoulder stability and should be addressed with bone augmentation when it is too deep. Here, we introduce a method of arthroscopic bone grafting of the humeral head for the treatment of a deep Hill-Sachs lesion in patients with anterior shoulder instability. Our indication for this procedure is a deep off-track Hill-Sachs lesion measuring at least 8 mm in depth and 10 mm in width. The main steps of this procedure include graft placement via special shoulder bone grafting instruments, graft suspension fixation using suture anchors, and bone fragment compression using the infraspinatus tendon. We routinely use this technique in combined treatment procedures for complicated anterior shoulder instability.

Surgical Repair of Bankart lesion in Recurrent Shoulder Dislocation: a Comparative and Retrospective Study between Open and Arthroscopic Technique

Surgical Repair of Bankart lesion in Recurrent Shoulder Dislocation: a Comparative and Retrospective Study between Open and Arthroscopic Technique

Acute Versus Delayed Magnetic Resonance Imaging and Associated Abnormalities in Traumatic Anterior Shoulder Dislocations.

Background:The delayed management of patients with shoulder instability may increase the prevalence and severity of concomitant intra-articular shoulder injuries resulting from persistent subluxations and dislocations.Hypothesis:Patients with a longer delay from the initial dislocation event to undergoing magnetic resonance imaging (MRI) or magnetic resonance arthrography will demonstrate more subluxations or dislocations and a greater amount of intra-articular shoulder damage.Study Design:Cohort study; Level of evidence, 3.Methods:We performed a retrospective review of 89 patients from a single institution with clinically and radiographically confirmed primary traumatic anterior shoulder dislocations. Patients were divided into 2 groups: those undergoing MRI less than 6 months (n = 44; LT6) or greater than 6 months (n = 45; GT6) from the initial dislocation event. The MRI assessment included evaluation of soft tissue injuries, including the labrum, capsule, rotator cuff, and cartilage damage severity along with bone loss.Results:The delayed MRI group (GT6) demonstrated a greater degree of intra-articular abnormalities compared to the early MRI group (LT6). A greater percentage of superior labral anterior-posterior (SLAP) tears (58% vs 34%, respectively) and cartilage damage (73% vs 27%, respectively) was present in the GT6 group compared to the LT6 group. Cartilage damage was 18% mild, 7% moderate, and 2% severe for the LT6 group as compared to 38% mild, 31% moderate, and 4% severe for the GT6 group. Additionally, more recurrent shoulder dislocations were seen in the GT6 group (n = 6) compared to the LT6 group (n = 2). In the LT6 group, there were more rotator cuff tears (50% vs 24%, respectively) and capsular tears (25% vs 9%, respectively) than the GT6 group. There was no difference in anterior glenoid bone loss, glenoid version, or humeral head subluxation between the 2 groups.Conclusion:Patients who undergo MRI greater than 6 months from the time of primary or initial shoulder dislocation had significantly more recurrent shoulder instability events and demonstrated a greater incidence and severity of intra-articular abnormalities, including SLAP tears, posterior labral tears, and anterior glenoid cartilage damage.

The Posterior Unstable Shoulder: Natural History, Clinical Evaluation and Imaging.

Background:There is a low incidence of posterior instability which is present in only 2% to 10% of all unstable shoulders. The posterior instable shoulder includes different manifestations like fixed dislocation, recurrent subluxation or dislocation.Methods:Research and online content related to posterior instability is reviewed. Natural history, clinical evaluation and imaging are described.Results:An awareness of the disorder, together with a thoughtful evaluation, beginning with the clinical history, usually leads to proper diagnosis. An appropriate physical exam, taking in account hyperlaxity and specific tests for posterior instability should be done.Conclusion:Posterior shoulder instability is an uncommon condition and is challenging to diagnose. There is not a single injury that is responsible for all cases of recurrent shoulder dislocation or subluxation, and the presence of soft tissue lesions or bone alterations should be evaluated, with the use of adequate simple radiology and multiplanar imaging.

Long-term efficacy of modified Bristow-Latarjet procedure in treatment of recurrent inferoanterior shoulder dislocation

Objective To investigate the long-term effects of modified Bristow-Latarjet operation for treatment of recurrent inferoanterior shoulder dislocation. Methods A retrospective case series study was done on 90 patients with recurrent inferoanterior shoulder dislocation treated by modified Bristow-Latarjet procedure from January 2001 to January 2016. There were 72 males and 18 females, with an average age of 36.8 years. There were 59 right shouders and 31 left shoulders, with dislocation for 4-32 times (mean, 13 times). Shoulder instability severity index score (ISIS) was 3-10 points (mean, 6.4 points). The duration of disease was 6-26 months (mean, 13 months). The operation methods were coracoid lateral incision with modification, rotator cuff interval approach, double hollow compression screw fixation, and bone congruent-arc technique in standing position. Clinical evaluation was done on postoperative recurrence of shoulder joint dislocation/subluxation, bone healing evaluated by X-ray and CT, Rowe score, simple shoulder function Test (SST) score, shoulder osteoarthritis score (Samilson-Prieto), body side shoulder external rotation angle and the subscapularis muscle strength. Results All patients were followed up for1-15 years (mean, 5.6 years). The rate of redislocation or subluxation during follow-up was zero. All transpositions of the coracoid got bone healing at postoperative 3-6 months. The Rowe score was increased significantly from (45.6±9.4)points preoperatively to (92.6±3.5)points postoperatively (P 0.05). With regards to subscapularis strength, the lift-off and belly-press in injured side were (4.9±0.9)kg and (4.4±1.0)kg, respectively (P>0.05). Lift-off and belly-off in normal side were (5.1±0.5)kg and (4.7±1.1)kg, respectively (P>0.05). Conclusion The modified Bristow-Latarjet operation is a reproducible and effective technique that can restore shoulder stability, with advantages of sound bone healing, free shoulder external rotation, low incidence of shoulder joint osteoarthritis, remaining of myodynamia under scapula and hence has long-term effects and is worth of clinical applicaiton. Key words: Shoulder joint; Shoulder dislocation; Bristow procedure

A case in which a capnometer was useful for diagnosing laryngospasm following administration of sugammadex

BackgroundSugammadex has been reported to cause upper-airway obstruction, such as laryngospasm or bronchospasm. These two conditions are treated using different approaches, but the differential diagnosis is difficult.Case presentationWe describe a case in which general anesthesia was administered via endotracheal intubation, in combination with brachial-plexus block, for arthroscopic surgical treatment of a rotator-cuff tear caused by recurrent shoulder dislocation. The total dose of rocuronium administered was 90 mg, and the last dose of 10 mg was given 15 min before the end of the surgery. Sugammadex was intravenously administered at 100 mg to reverse the effect of rocuronium after the operation ended. After extubation in this case, we placed a mask firmly around the patient’s mouth, and thus, there was no air leakage around the mask. We detected upper-airway obstruction that was presumably attributable to administration of sugammadex. The end-tidal carbon dioxide (EtCO2) concentration was undetectable on a capnometer. Although 100% oxygen was administered at 10 L/min via a facemask, oxygen saturation (SpO2) decreased to approximately 70%. With suspected onset of laryngospasm, continuous positive airway pressure with 100% oxygen at 10 L/min was started at 30 cm H2O. The patient’s airway obstruction resolved after a short time.ConclusionThe use of a capnometer facilitated the diagnosis of laryngospasm and allowed us to administer appropriate treatment after administration of sugammadex.

Latarjet procedure: evolution of the bone block and correspondent clinical relevance-a clinical and radiological study.

The purpose of this study was to correlate the bone block graft position, its dimension, its reabsorption and its integration with clinical outcome in patients operated on for recurrent anterior shoulder instability. Twenty-four patients affected by recurrent anterior shoulder dislocation and operated on using the Latarjet procedure were enrolled in this study. At 6 and 24months, patients were evaluated with the following scales: ROWE, WOSI, Oxford instability score, UCLA, DASH and Constant score. Patients underwent two postoperative CT scans: immediately after surgery (T0) and at 24months post-op (T1). At 24months, none of the 24 patients reported further episodes of dislocation. Clinically at the final follow-up, we found excellent results in all the evaluation scales. Mean reduction in bone graft from T0 to T1 was 42% of the overall volume; similarly reduction in the overall surface was 29.3%; decrease in length, width and depth was, respectively, 3.4, 2.2 and 1.0mm; all these parameters decreased significantly (p<0.05). No correlations were found between radiological parameters and clinical and functional outcomes. The results confirm that a lack of integration or a significant reabsorption of the graft is present in the Latarjet procedure, but they do not significantly affect the clinical and functional results.

Ha-Eri Chari procedure for recurrent anterior dislocation of shoulder

Background: To evaluate the functional outcome following Ha-Eri Chari procedure as treatment for recurrent anterior dislocation of shoulder. Materials and methods: This study is a prospective study. 20 patients aged 20 to 44, who underwent Ha-Eri chari procedure from 2014 to 2016 for recurrent anterior dislocation of the right (n=14) and left (n=6) shoulders were included in this study. The mean number of dislocations was 20. The patients were evaluated every 12 weeks during the first year and every 6 months thereafter. The mean follow-up period was 12 months. Outcome was evaluated using the Burkhead and Rockwood criteria. Results: Outcome was excellent in 16 patients, good in 4. None had poor outcome. The mean external rotation deficit at 00 and 900 of abduction improved. No patient had evidence of loosening, infection, re dislocation, migration of coracoid screw or glenohumeral arthritis. Conclusion: Ha-Eri Chari procedure is a viable and simple treatment for recurrent anterior shoulder dislocation. This procedure is relatively simple and can be performed by all orthopaedic surgeons without the need of specialised arthroscopic instruments.

The morphological examination of cervical nerve roots using ultrasound in rotator cuff tear, frozen shoulder, and recurrent anterior shoulder dislocation

The morphological examination of cervical nerve roots using ultrasound in rotator cuff tear, frozen shoulder, and recurrent anterior shoulder dislocation

Analysis of postoperative monitoring of patients undergoing shoulder arthroscopy for anterior instability

ObjectiveAnalyze the postoperative follow-up of patients undergoing shoulder arthroscopy for treatment of anterior instability and correlate with the prevalence of recurrence. MethodsA six-question survey was applied by phone and mail to 65 patients, seeking information on the current result of the surgical procedure. All patients were treated arthroscopically for anterior shoulder instability, with at least 12 months of postoperative time. Patients with associated posterior labial lesions and revision surgeries were not included. ResultsAt the time of the survey the patients had a median of 56 (IQR: 34.5–110.5) postoperative months. The mean sample age was 24.6 years (maximum=47, minimum=12; SD=7.3). Complaint of pain in the shoulder was observed in 20 patients (30.7%). Dislocation recurrence was observed in 10 patients (15.3%). Forty-four patients (67.6%) considered their shoulder normal, which was more frequent in non-recurrence patients (p<0.001). Forty-three patients (66.1%) returned to their previous level of sport and there was no difference between recurrence and non-recurrence patients (p=0.456). It was found that the prevalence of recurrence was 5.6 (95% CI: 1.30–24.46) times higher in individuals who abandoned monitoring before six months postoperatively (p=0.012). ConclusionThe abandonment of postoperative monitoring in the early stages, when the patients receive orientation for muscle strengthening, proprioceptive education, and dangerous movements to avoid, can increase the rates of recurrent shoulder dislocation in patients treated for anterior instability by arthroscopy.

Functional Outcome Following Bristow and Boytchev Surgery in Recurrent Dislocation of Shoulder

Functional Outcome Following Bristow and Boytchev Surgery in Recurrent Dislocation of Shoulder

Complications of coracoid transfer procedures for the treatment of recurrent shoulder dislocation

BackgroundDifferent surgical procedures have been described for the treatment of the recurrent anterior dislocation of the shoulder. Despite the documented success of the open procedures, some studies suggest that the arthroscopic technique leads to more favorable results. However, there still seems to be some disagreement concerning the incidence of complications, when comparing open and arthroscopic techniques. Objective and methodsAs an attempt to clarify these doubts about the incidence of complications associated with the different techniques, this study contains a free literature review along with a retrospective case series of the patients who underwent these procedures in an University hospital in the past 10 years. Discussion and conclusionThere are various techniques for the treatment of the recurrent dislocation of the shoulder, all of them with known success when it comes to prevention of recurrence. However, all of them are invariably associated with high complication rates.Despite being associated with a slightly higher re-operation rate, in the literature, the arthroscopic technique was found to have an overall lower rate of complications when compared to the open procedures. Centro Hospitalar São João (CHSJ) presented a higher rate of screw related complications and revision surgery than the literature. However, concerning other complications and when assessing the procedures individually, no tendency was verified. One can therefore conclude that, despite being scarce, the Centro Hospitalar São João CHSJ data roughly overlap the literature.

Arthroscopic Versus Open Latarjet in the Treatment of Recurrent Anterior Shoulder Dislocation With Marked Glenoid Bone Loss: A Prospective Comparative Study

Background: Very few studies have compared open Latarjet versus arthroscopic Latarjet procedures. Purpose: To compare the clinical and computed tomographic outcomes between open and arthroscopic Latarjet procedures. Study Design: Cohort study; Level of evidence, 3. Methods: A prospective, comparative study was performed. The open Latarjet group included 44 patients, and the arthroscopic Latarjet group included 46 patients. All patients had more than 2 years of clinical follow-up (range of motion, American Shoulder and Elbow Surgeons [ASES] score, Constant-Murley score, and Rowe score). The position of the transferred coracoid, the screw orientation, and graft resorption were evaluated on computed tomography (CT) scan. Results: The surgery time for the open group was significantly shorter than that for the arthroscopic group (P = .003). No recurrent dislocation occurred in either group. The apprehension test was negative in all patients in both groups. At the final follow-up, no significant difference was detected between the open group and the arthroscopic group regarding any of the clinical outcome measurements. The transferred coracoid graft was level with the glenoid in all patients in both groups. The open group had better position in the superior-inferior direction compared with the arthroscopic group (P < .001). No significant difference was found in screw orientation between the 2 groups (P = .102). At 1 year after surgery, patients in the arthroscopic group had significantly less resorption compared with patients in the open group (P = .044). Conclusion: Both procedures are effective for the treatment of recurrent anterior shoulder dislocation with marked glenoid bone loss. The open group had better position in the superior-inferior direction compared with the arthroscopic group. At 1 year after surgery, patients in the arthroscopic Latarjet group showed notably less graft resorption compared with patients in the open Latarjet group.

Unclassified MR arthrography pattern evaluation in patients with episodes of recurrent antero-inferior shoulder dislocation.

To evaluate prospectively the incidence of unclassifiable MR arthrography patterns of glenoid anterior-inferior labrum lesions, in patients with at least two episodes of recurrent antero-inferior shoulder dislocation. The MR shoulder Arthrography images of 36 patients, with at least two episodes of recurrent antero-inferior dislocation, were prospectively evaluated, during a period between November 2015 and Mai 2016. All patients were contacted after 6months of the MR arthrography to evaluate their course of treatment. The MR arthrography images were analyzed by two radiologists, respectively with 5 and 15 years of experience in musculoskeletal radiology. 36 cases of unclassifiable MR arthrography pattern of the anterior-inferior glenoid labrum were evaluated: in 13 out 36 cases (36.1%), the glenoid labrum has been described as "oedematous and swollen"; in 19 out 36 cases (52.8%), it has been described as "smooth" (not hypoplastic); in 4 out 36 cases (11.1%), it has been described as degenerated. The unclassifiable MR arthrography patterns of fibrocartilage glenoid lesions after episodes of recurrent antero-inferior dislocation are commons. The unclassifiable MR arthrography patterns require a careful consideration, in order to improve the diagnostic and therapeutic multidisciplinary approach.