Arthroscopic nomenclature of capsulolabral appearances in anterior shoulder dislocation

Kanthalu Narayanan Subramanian; Deepak Channabasappa Eswarappa; Ganesh Prajwal Senthilnathan; Muthukumar Subramanian; Rajesh Sellappan

doi:10.1016/j.jor.2021.03.016

Arthroscopic nomenclature of capsulolabral appearances in anterior shoulder dislocation

J Orthop. 2021 Apr 14:25:120-123. doi: 10.1016/j.jor.2021.03.016. eCollection 2021 May-Jun.

Authors

Kanthalu Narayanan Subramanian¹, Deepak Channabasappa Eswarappa², Ganesh Prajwal Senthilnathan³, Muthukumar Subramanian¹, Rajesh Sellappan⁴

Affiliations

¹ Velammal Medical College, Madurai, India.
² Wrightington Hospital, Wigan, United Kingdom.
³ Rajam Nursing Home, Tiruvannamalai, India.
⁴ Apollo Hospital, Karur, India.

Abstract

Objectives: To study the intraoperative morphology of the glenoid labrum and capsule in recurrent shoulder dislocation and to study the relationship between the number of dislocations and the changes in the glenoid and labrum.

Methods: Over a period of 18 months, 108 patients with traumatic anterior dislocations were included in the study, of which 102 men and 6 women with mean age of 33.4yrs range from 18 to 45. The patients with bony bankart, other labral lesions, ligamentous laxity, SLAP tear were excluded from the study. All the patients underwent arthroscopic bankart repair. We have classified the morphology of labrum and capsule on their appearance intraoperatively. Labrum is named as Normal, Desiccated or Shredded and Capsule as Normal or Damaged.

Results: Six varieties of appearances were observed. Namely, Normal capsule and Normal labrum (NN), Normal capsule and Desiccated labrum (ND), Normal capsule and Shredded labrum (NS), Damaged capsule and Normal labrum (DN), Damaged capsule and Desiccated labrum(DD), Damaged capsule and Shredded labrum(DS). Among them, DD (33.3%) and DS (29.6%) variety had highest number of dislocations suggesting the labrum and capsule lose normal anatomy with more recurrence of dislocations.

Conclusion: These findings support that reproducing normal anatomy after surgical repair is possible when the intervention is done sooner than later.

Level of evidence: III.

Keywords: Bankart; Capsule; Ligament; Shoulder dislocation.