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Labrum and Instability Lesions, Shoulder: Postoperative Imaging
Soterios Gyftopoulos, MD, MSc; Michael J. Tuite, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Clinical Issues

        TERMINOLOGY

        • Synonyms

          • Bankart repair, superior labrum anterior and posterior (SLAP) repair, reverse Bankart repair
        • Definitions

          • Repair of torn labrum &/or inferior glenohumeral ligament
            • May be performed arthroscopically or as open procedure
          • Standard procedures
            • Debridement of frayed labrum
            • Repair torn labrum using sutures tied to metal anchors or bioabsorbable screws/tacks embedded into glenoid
            • Capsulorrhaphy (sutures, laser, or radiofrequency) to tighten capsule and inferior glenohumeral ligament
            • Remplissage (suturing capsule + tendon, often infraspinatus) or bone grafts for large Hill-Sachs lesions, and Latarjet procedure for severe glenoid rim deficiency
              • Latarjet more common than remplissage

        IMAGING

        • General Features

          • Radiographic Findings

            • MR Findings

              • Imaging Recommendations

                DIFFERENTIAL DIAGNOSIS

                  PATHOLOGY

                  • General Features

                    CLINICAL ISSUES

                    • Presentation

                      • Demographics

                        • Natural History & Prognosis

                          • Treatment

                            Selected References

                            1. Arner JW et al: Anterior shoulder instability management: indications, techniques, and outcomes. Arthroscopy. 36(11):2791-3, 2020
                            2. Choi BH et al: Superior labral cleft after superior labral anterior-to-posterior tear repair: CT arthrographic features and correlation with clinical outcome. Radiology. 278(2):441-8, 2016
                            3. Kurji HM et al: Magnetic resonance imaging arthrography following type II superior labrum from anterior to posterior repair: interobserver and intraobserver reliability. Open Access J Sports Med. 6:329-35, 2015
                            4. Plath JE et al: Arthroscopic suture anchor fixation of bony Bankart lesions: clinical outcome, magnetic resonance imaging results, and return to sports. Arthroscopy. 31(8):1472-81, 2015
                            5. Stein T et al: MRI assessment of the structural labrum integrity after Bankart repair using knotless bio-anchors. Knee Surg Sports Traumatol Arthrosc. 19(10):1771-9, 2011
                            6. Baker CL 3rd et al: Combined arthroscopic repair of a type IV SLAP tear and Bankart lesion. Arthroscopy. 25(9):1045-50, 2009
                            7. Brockmeier SF et al: Outcomes after arthroscopic repair of type-II SLAP lesions. J Bone Joint Surg Am. 91(7):1595-603, 2009
                            8. Oh JH et al: Clinical and radiologic outcomes of arthroscopic glenoid labrum repair with the BioKnotless suture anchor. Am J Sports Med. 37(12):2340-8, 2009
                            9. Tokish JM et al: Arthroscopic repair of circumferential lesions of the glenoid labrum. J Bone Joint Surg Am. 91(12):2795-802, 2009
                            10. van der Woude HJ: Magnetic resonance imaging after surgery for shoulder instability. JBR-BTR. 92(1):43-8, 2009
                            11. Yoo JC et al: Magnetic resonance imaging appearance of a repaired capsulolabral complex after arthroscopic bankart repair. Am J Sports Med. 36(12):2310-6, 2008
                            12. Probyn LJ et al: Recurrent symptoms after shoulder instability repair: direct MR arthrographic assessment--correlation with second-look surgical evaluation. Radiology. 245(3):814-23, 2007
                            13. Major NM et al: MR imaging of complications of loose surgical tacks in the shoulder. AJR Am J Roentgenol. 180(2):377-80, 2003
                            14. Volpi D et al: Capsulo-labro-ligamentous lesions of the shoulder: evaluation with MR arthrography. Radiol Med. 105(3):162-70, 2003
                            15. Sugimoto H et al: MR arthrography of shoulders after suture-anchor Bankart repair. Radiology. 224(1):105-11, 2002
                            16. Wagner SC et al: Shoulder instability: accuracy of MR imaging performed after surgery in depicting recurrent injury--initial findings. Radiology. 222(1):196-203, 2002
                            Related Anatomy
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                            Related Differential Diagnoses
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                            References
                            Tables

                            Tables

                            KEY FACTS

                            • Terminology

                              • Imaging

                                • Clinical Issues

                                  TERMINOLOGY

                                  • Synonyms

                                    • Bankart repair, superior labrum anterior and posterior (SLAP) repair, reverse Bankart repair
                                  • Definitions

                                    • Repair of torn labrum &/or inferior glenohumeral ligament
                                      • May be performed arthroscopically or as open procedure
                                    • Standard procedures
                                      • Debridement of frayed labrum
                                      • Repair torn labrum using sutures tied to metal anchors or bioabsorbable screws/tacks embedded into glenoid
                                      • Capsulorrhaphy (sutures, laser, or radiofrequency) to tighten capsule and inferior glenohumeral ligament
                                      • Remplissage (suturing capsule + tendon, often infraspinatus) or bone grafts for large Hill-Sachs lesions, and Latarjet procedure for severe glenoid rim deficiency
                                        • Latarjet more common than remplissage

                                  IMAGING

                                  • General Features

                                    • Radiographic Findings

                                      • MR Findings

                                        • Imaging Recommendations

                                          DIFFERENTIAL DIAGNOSIS

                                            PATHOLOGY

                                            • General Features

                                              CLINICAL ISSUES

                                              • Presentation

                                                • Demographics

                                                  • Natural History & Prognosis

                                                    • Treatment

                                                      Selected References

                                                      1. Arner JW et al: Anterior shoulder instability management: indications, techniques, and outcomes. Arthroscopy. 36(11):2791-3, 2020
                                                      2. Choi BH et al: Superior labral cleft after superior labral anterior-to-posterior tear repair: CT arthrographic features and correlation with clinical outcome. Radiology. 278(2):441-8, 2016
                                                      3. Kurji HM et al: Magnetic resonance imaging arthrography following type II superior labrum from anterior to posterior repair: interobserver and intraobserver reliability. Open Access J Sports Med. 6:329-35, 2015
                                                      4. Plath JE et al: Arthroscopic suture anchor fixation of bony Bankart lesions: clinical outcome, magnetic resonance imaging results, and return to sports. Arthroscopy. 31(8):1472-81, 2015
                                                      5. Stein T et al: MRI assessment of the structural labrum integrity after Bankart repair using knotless bio-anchors. Knee Surg Sports Traumatol Arthrosc. 19(10):1771-9, 2011
                                                      6. Baker CL 3rd et al: Combined arthroscopic repair of a type IV SLAP tear and Bankart lesion. Arthroscopy. 25(9):1045-50, 2009
                                                      7. Brockmeier SF et al: Outcomes after arthroscopic repair of type-II SLAP lesions. J Bone Joint Surg Am. 91(7):1595-603, 2009
                                                      8. Oh JH et al: Clinical and radiologic outcomes of arthroscopic glenoid labrum repair with the BioKnotless suture anchor. Am J Sports Med. 37(12):2340-8, 2009
                                                      9. Tokish JM et al: Arthroscopic repair of circumferential lesions of the glenoid labrum. J Bone Joint Surg Am. 91(12):2795-802, 2009
                                                      10. van der Woude HJ: Magnetic resonance imaging after surgery for shoulder instability. JBR-BTR. 92(1):43-8, 2009
                                                      11. Yoo JC et al: Magnetic resonance imaging appearance of a repaired capsulolabral complex after arthroscopic bankart repair. Am J Sports Med. 36(12):2310-6, 2008
                                                      12. Probyn LJ et al: Recurrent symptoms after shoulder instability repair: direct MR arthrographic assessment--correlation with second-look surgical evaluation. Radiology. 245(3):814-23, 2007
                                                      13. Major NM et al: MR imaging of complications of loose surgical tacks in the shoulder. AJR Am J Roentgenol. 180(2):377-80, 2003
                                                      14. Volpi D et al: Capsulo-labro-ligamentous lesions of the shoulder: evaluation with MR arthrography. Radiol Med. 105(3):162-70, 2003
                                                      15. Sugimoto H et al: MR arthrography of shoulders after suture-anchor Bankart repair. Radiology. 224(1):105-11, 2002
                                                      16. Wagner SC et al: Shoulder instability: accuracy of MR imaging performed after surgery in depicting recurrent injury--initial findings. Radiology. 222(1):196-203, 2002