Research progress on the relationship between shoulder instability and superior labrum anterior posterior lesion_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

FENG Sijia ^1,2 , CHEN Jun ^1,2 , ZHANG Jian ^1,2 ,  CHEN Shiyi ^1,2

1. Sports Medicine Institute, Fudan University, Shanghai, 200040, P. R. China;
2. Department of Sports Medicine, Huashan Hospital Affiliated to Fudan University, Shanghai, 200040, P. R. China;

Corresponding author：

CHEN Shiyi, Email: cshiyi@163.com

Keywords：

Shoulder instability; superior labrum anterior posterior lesion; glenoid labrum; long head of biceps tendon

DOI：

10.7507/1002-1892.202108078

Video：

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Objective To summarize the relationship between shoulder instability and superior labrum anterior posterior (SLAP) lesion. Methods The characteristics of shoulder instability and SLAP lesion were analyzed, and the relationship between them in pathogenesis, clinical symptoms, and biomechanics was discussed by referring to relevant domestic and foreign literature. Results Shoulder instability and SLAP lesion can occur both spontaneously and respectively. SLAP lesion destroys the superior labrum integrity and the long head of biceps tendon (LHBT) insertion, causing excessive humeral head displacement against glenoid, and leading to shoulder instability. While chronic repetitive or acute high-energy traumatic shoulder instability can in turn aggravate SLAP lesion, resulting in expansion and increased degree of the original lesion. Conclusion SLAP lesion destroys mechanisms of shoulder stability, while shoulder instability causes tears of the upper labrum and the LHBT, showing a connection between shoulder instability and SLAP lesion. However, the existing evidence can only demonstrate that shoulder instability and SLAP lesion induce and promote the development of each other, instead of a necessary and sufficient condition. Therefore, the specific causal relationship between the two remains unknown and needs to be further studied.

Citation： FENG Sijia, CHEN Jun, ZHANG Jian, CHEN Shiyi. Research progress on the relationship between shoulder instability and superior labrum anterior posterior lesion. Chinese Journal of Reparative and Reconstructive Surgery, 2022, 36(2): 135-142. doi: 10.7507/1002-1892.202108078 Copy

1.	Tuite MJ, Pfirrmann CWA. Shoulder: instability//Musculoskeletal diseases 2021-2024: Diagnostic Imaging. Cham (CH): Springer, 2021: 1-9.
2.	Zacchilli MA, Owens BD. Epidemiology of shoulder dislocations presenting to emergency departments in the United States. J Bone Joint Surg (Am), 2010, 92(3): 542-549.
3.	Pappas AM, Goss TP, Kleinman PK. Symptomatic shoulder instability due to lesions of the glenoid labrum. Am J Sports Med, 1983, 11(5): 279-288.
4.	Andrews JR, Carson WG, McLeod WD. Glenoid labrum tears related to the long head of the biceps. Am J Sports Med, 1985, 13(5): 337-341.
5.	Snyder SJ, Banas MP, Karzel RP. An analysis of 140 injuries to the superior glenoid labrum. J Shoulder Elbow Surg, 1995, 4(4): 243-248.
6.	Varacallo M, Tapscott DC, Mair SD. Superior labrum anterior posterior lesions [M/OL]. Treasure Island: StatPearls Publishing, 2021[2021-10-20]. https://www.ncbi.nlm.nih.gov/books/NBK538284/?report=printable.
7.	Varacallo M, Seaman TJ, Mair SD. Biceps tendon dislocation and instability [M/OL]. Treasure Island: StatPearls Publishing, 2021[2021-10-20]. https://pubmed.ncbi.nlm.nih.gov/30475566/.
8.	Abboud JA, Soslowsky LJ. Interplay of the static and dynamic restraints in glenohumeral instability. Clin Orthop Relat Res, 2002, (400): 48-57.
9.	陈世益, 冯华. 现代骨科运动医学. 上海: 复旦大学出版社, 2020: 153-154.
10.	Gerber C, Nyffeler RW. Classification of glenohumeral joint instability. Clin Orthop Relat Res, 2002, (400): 65-76.
11.	Almekinders LC, Temple JD. Etiology, diagnosis, and treatment of tendonitis: an analysis of the literature. Med Sci Sports Exerc, 1998, 30(8): 1183-1190.
12.	Cooper DE, Arnoczky SP, O’Brien SJ, et al. Anatomy, histology, and vascularity of the glenoid labrum. J Bone Joint Surg (Am), 1992, 74(1): 46-52.
13.	Wilk KE, Andrews JR, Arrigo CA. The physical examination of the glenohumeral joint: emphasis on the stabilizing structures. J Orthop Sports Phys Ther, 1997, 25(6): 380-389.
14.	Wilk KE, Arrigo CA, Andrews JR. Current concepts: the stabilizing structures of the glenohumeral joint. J Orthop Sports Phys Ther, 1997, 25(6): 364-379.
15.	Rowe CR, Zarins B. Recurrent transient subluxation of the shoulder. J Bone Joint Surg (Am), 1981, 63(6): 863-872.
16.	Van Blarcum GS, Svoboda SJ. Glenohumeral instability related to special conditions: SLAP tears, pan-labral tears, and multidirectional instability. Sports Med Arthrosc Rev, 2017, 25(3): e12-e17.
17.	Marco SM, Lafuente JLÁ, Ibán MAR, et al. Controversies in the surgical management of shoulder instability: associated soft tissue procedures. Open Orthop J, 2017, 11: 989-1000.
18.	Tokish JM, McBratney CM, Solomon DJ, et al. Arthroscopic repair of circumferential lesions of the glenoid labrum. J Bone Joint Surg (Am), 2009, 91(12): 2795-2802.
19.	Yiannakopoulos CK, Mataragas E, Antonogiannakis E. A comparison of the spectrum of intra-articular lesions in acute and chronic anterior shoulder instability. Arthroscopy, 2007, 23: 985-990.
20.	Kim SH, Ha KI, Choi HJ. Results of arthroscopic treatment of superior labral lesions. J Bone Joint Surg (Am), 2002, 84(6): 981-985.
21.	Ide J, Maeda S, Takagi K. Sports activity after arthroscopic superior labral repair using suture anchors in overhead-throwing athletes. Am J Sports Med, 2005, 33(4): 507-514.
22.	Maffet MW, Gartsman GM, Moseley B. Superior labrum-biceps tendon complex lesions of the shoulder. Am J Sports Med, 1995, 23(1): 93-98.
23.	Morgan CD, Burkhart SS, Palmeri M, et al. Type Ⅱ SLAP lesions: three subtypes and their relationships to superior instability and rotator cuff tears. Arthroscopy, 1998, 14(6): 553-565.
24.	Boileau P, Parratte S, Chuinard C, et al. Arthroscopic treatment of isolated type Ⅱ SLAP lesions: Biceps tenodesis as an alternative to reinsertion. Am J Sports Med, 2009, 37(5): 929-936.
25.	Musgrave DS, Rodosky MW. SLAP lesions: current concepts. Am J Orthop (Belle Mead NJ), 2001, 30(1): 29-38.
26.	徐文杰, 刘沛东, 张城铭, 等. 肩关节SLAP损伤机制与治疗的研究进展. 实用骨科杂志, 2021, 27(4): 335-340.
27.	Snyder SJ, Karzel RP, Del Pizzo W, et al. SLAP lesions of the shoulder. Arthroscopy, 1990, 6(4): 274-279.
28.	Handelberg F, Willems S, Shahabpour M, et al. SLAP lesions: a retrospective multicenter study. Arthroscopy, 1998, 14(8): 856-862.
29.	Feng S, Song Y, Li H, et al. Outcomes for arthroscopic repair of combined Bankart/SLAP lesions in the treatment of anterior shoulder instability: a systematic review and meta-analysis. Orthop J Sports Med, 2019, 7(10): 2325967119877804. doi: 10.1177/2325967119877804.
30.	Powell SE, Nord KD, Ryu RKN. The diagnosis, classification, and treatment of SLAP lesions. Oper Tech Sports Med, 2004, 12: 99-110.
31.	Sheean AJ, Arner JW, Bradley JP. Posterior glenohumeral instability: diagnosis and management. Arthroscopy, 2020, 36(10): 2580-2582.
32.	Kandeel AA. Type Ⅴ superior labral anterior-posterior (SLAP) lesion in recurrent anterior glenohumeral instability. J Shoulder Elbow Surg, 2020, 29(1): 95-103.
33.	Hantes ME, Venouziou AI, Liantsis AK, et al. Arthroscopic repair for chronic anterior shoulder instability: a comparative study between patients with Bankart lesions and patients with combined Bankart and superior labral anterior posterior lesions. Am J Sports Med, 2009, 37(6): 1093-1098.
34.	Burkhart SS, Morgan C. SLAP lesions in the overhead athlete. Orthop Clin North Am, 2001, 32(3): 431-441.
35.	Cho H, Lee C, Hwang T, et al. Arthroscopic repair of combined Bankart and SLAP lesions: operative techniques and clinical results. Clin Orthop Surg, 2010, 2(1): 39-46.
36.	Zhu M, Chen JY, Chong HC, et al. Comparative study on clinical results of arthroscopic repair of anteroinferior, superior, and combined glenoid labral tear. J Orthop Surg (Hong Kong), 2018, 26(1): 2309499018762619. doi: 10.1016/j.arthro.2017.08.081.
37.	Durban CM, Kim JK, Kim SH, et al. Anterior shoulder instability with concomitant superior labrum from anterior to posterior (SLAP) lesion compared to anterior instability without SLAP lesion. Clin Orthop Surg, 2016, 8(2): 168-174.
38.	Kim DS, Yi CH, Yoon YS. Arthroscopic repair for combined Bankart and superior labral anterior posterior lesions: a comparative study between primary and recurrent anterior dislocation in the shoulder. Int Orthop, 2011, 35(8): 1187-1195.
39.	Owens BD, Nelson BJ, Deberardino TM. Arthroscopic repair of combined labral lesions. Tech Shoulder Elbow Surg, 2008, 9: 10-14.
40.	Ogul H, Ayyildiz V, Pirimoglu B, et al. Magnetic resonance arthrographic demonstration of association of superior labrum anterior and posterior lesions with extended anterior labral tears. J Comput Assist Tomogr, 2019, 43(1): 51-60.
41.	Özer M, Kaptan AY, Ataoglu MB, et al. The Buford complex: prevalence and relationship with labral pathologies. J Shoulder Elbow Surg, 2021, 30(6): 1356-1361.
42.	Schultz KA, Nelson R. Superior labrum lesions [M/OL]. Treasure Island: StatPearls Publishing, 2021. https://pubmed.ncbi.nlm.nih.gov/32491594/.
43.	Nishinaka N, Uehara T, Tsutsui H. Recurrent posterior dislocation of the shoulder associated with the Buford complex. J Clin Orthop Trauma, 2016, 7(1): 55-60.
44.	Antonio GE, Griffith JF, Yu AB, et al. First-time shoulder dislocation: High prevalence of labral injury and age-related differences revealed by MR arthrography. J Magn Reson Imaging, 2007, 26(4): 983-991.
45.	Knesek M, Skendzel JG, Dines JS, et al. Diagnosis and management of superior labral anterior posterior tears in throwing athletes. Am J Sports Med, 2013, 41(2): 444-460.
46.	Kibler WB, Sciascia A. Current practice for the diagnosis of a SLAP lesion: systematic review and physician survey. Arthroscopy, 2015, 31: 2456-2469.
47.	Virk MS, Arciero RA. Superior labrum anterior to posterior tears and glenohumeral instability. Instr Course Lect, 2013, 62: 501-514.
48.	Rodosky MW, Harner CD, Fu FH. The role of the long head of the biceps muscle and superior glenoid labrum in anterior stability of the shoulder. Am J Sports Med, 1994, 22(1): 121-130.
49.	McMahon PJ, Burkart A, Musahl V, et al. Glenohumeral translations are increased after a type Ⅱ superior labrum anterior-posterior lesion: a cadaveric study of severity of passive stabilizer injury. J Shoulder Elbow Surg, 2004, 13(1): 39-44.
50.	Pagnani MJ, Deng XH, Warren RF, et al. Effect of lesions of the superior portion of the glenoid labrum on glenohumeral translation. J Bone Joint Surg (Am), 1995, 77(7): 1003-1010.
51.	Burkart A, Debski R, Musahl V, et al. Glenohumeral translations are only partially restored after repair of a simulated type Ⅱ superior labral lesion. Am J Sports Med, 2003, 31(1): 56-63.
52.	Strauss EJ, Salata MJ, Sershon RA, et al. Role of the superior labrum after biceps tenodesis in glenohumeral stability. J Shoulder Elbow Surg, 2014, 23(4): 485-491.
53.	Burkhart SS, Morgan CD. The peel-back mechanism: its role in producing and extending posterior type Ⅱ SLAP lesions and its effect on SLAP repair rehabilitation. Arthroscopy, 1998, 14(6): 637-640.
54.	Mihata T, Lee Y, Mcgarry MH, et al. Excessive humeral external rotation results in increased shoulder laxity. Am J Sports Med, 2004, 32(5): 1278-1285.
55.	Mihata T, Mcgarry MH, Tibone JE, et al. Biomechanical assessment of type Ⅱ superior labral anterior-posterior (SLAP) lesions associated with anterior shoulder capsular laxity as seen in throwers: a cadaveric study. Am J Sports Med, 2008, 36(8): 1604-1610.
56.	Itoi E, Motzkin NE, Morrey BF, et al. Stabilizing function of the long head of the biceps in the hanging arm position. J Shoulder Elbow Surg, 1994, 3(3): 135-142.
57.	McFarland EG, Neira CA, Gutierrez MI, et al. Clinical significance of the arthroscopic drive-through sign in shoulder surgery. Arthroscopy, 2001, 17(1): 38-43.
58.	Rokito SE, Myers KR, Ryu RK. SLAP lesions in the overhead athlete. Sports Med Arthrosc Rev, 2014, 22(2): 110-116.
59.	Soslowsky LJ, Malicky DM, Blasier RB. Active and passive factors in inferior glenohumeral stabilization: a biomechanical model. J Shoulder Elbow Surg, 1997, 6(4): 371-379.
60.	Kim DS, Yi CH, Kwon KY, et al. Relationship between the extent of labral lesions and the frequency of glenohumeral dislocation in shoulder instability. Knee Surg Sports Traumatol Arthrosc, 2013, 21(2): 430-437.
61.	Kim TK, Mcfarland EG. Internal impingement of the shoulder in flexion. Clin Orthop Relat Res, 2004, 421: 112-119.
62.	Cohen DB, Coleman S, Drakos MC, et al. Outcomes of isolated type Ⅱ SLAP lesions treated with arthroscopic fixation using a bioabsorbable tack. Arthroscopy, 2006, 22(2): 136-142.
63.	Habermeyer P, Gleyze P, Rickert M. Evolution of lesions of the labrum-ligament complex in posttraumatic anterior shoulder instability: a prospective study. J Shoulder Elbow Surg, 1999, 8(1): 66-74.
64.	Milano G, Grasso A, Russo A, et al. Analysis of risk factors for glenoid bone defect in anterior shoulder instability. Am J Sports Med, 2011, 39(9): 1870-1876.
65.	Mazzocca AD, Brown FMJ, Carreira DS, et al. Arthroscopic anterior shoulder stabilization of collision and contact athletes. Am J Sports Med, 2005, 33(1): 52-60.
66.	Lo IK, Burkhart SS. Triple labral lesions: pathology and surgical repair technique-report of seven cases. Arthroscopy, 2005, 21(2): 186-193.
67.	Koss S, Richmond JC, Woodward JSJ. Two- to five-year follow up of arthroscopic Bankart reconstruction using a suture anchor technique. Am J Sports Med 1997, 25(6): 809-812.
68.	Gartsman GM, Roddey TS, Hammerman SM. Arthroscopic treatment of anterior-inferior glenohumeral instability. J Bone Joint Surg (Am), 2000, 82: 991-1003.
69.	Gutierrez V, Monckeberg JE, Pinedo M, et al. Arthroscopically determined degree of injury after shoulder dislocation relates to recurrence rate. Clin Orthop Relat Res, 2012, 470(4): 961-964.
70.	Sarikaya B, Bozkurt C, Gül O, et al. Comparison of the clinical results of isolated Bankart and SLAP 5 lesions after arthroscopic repair. Jt Dis Relat Surg, 2020, 31(2): 223-229.
71.	Glasgow SG, Bruce RA, Yacobucci GN, et al. Arthroscopic resection of glenoid labral tears in the athlete: a report of 29 cases. Arthroscopy, 1992, 8(1): 48-54.
72.	Yamaguchi K, Riew KD, Galatz LM, et al. Biceps activity during shoulder motion: an electromyographic analysis. Clin Orthop Relat Res, 1997, (336): 122-129.
73.	Itoigawa Y, Hooke AW, Sperling JW, et al. Bankart repair alone in combined Bankart and superior labral anterior-posterior lesions preserves range of motion without compromising joint stability. JSES Int, 2020, 4(1): 63-67.

1. Tuite MJ, Pfirrmann CWA. Shoulder: instability//Musculoskeletal diseases 2021-2024: Diagnostic Imaging. Cham (CH): Springer, 2021: 1-9.
2. Zacchilli MA, Owens BD. Epidemiology of shoulder dislocations presenting to emergency departments in the United States. J Bone Joint Surg (Am), 2010, 92(3): 542-549.
3. Pappas AM, Goss TP, Kleinman PK. Symptomatic shoulder instability due to lesions of the glenoid labrum. Am J Sports Med, 1983, 11(5): 279-288.
4. Andrews JR, Carson WG, McLeod WD. Glenoid labrum tears related to the long head of the biceps. Am J Sports Med, 1985, 13(5): 337-341.
5. Snyder SJ, Banas MP, Karzel RP. An analysis of 140 injuries to the superior glenoid labrum. J Shoulder Elbow Surg, 1995, 4(4): 243-248.
6. Varacallo M, Tapscott DC, Mair SD. Superior labrum anterior posterior lesions [M/OL]. Treasure Island: StatPearls Publishing, 2021[2021-10-20]. https://www.ncbi.nlm.nih.gov/books/NBK538284/?report=printable.
7. Varacallo M, Seaman TJ, Mair SD. Biceps tendon dislocation and instability [M/OL]. Treasure Island: StatPearls Publishing, 2021[2021-10-20]. https://pubmed.ncbi.nlm.nih.gov/30475566/.
8. Abboud JA, Soslowsky LJ. Interplay of the static and dynamic restraints in glenohumeral instability. Clin Orthop Relat Res, 2002, (400): 48-57.
9. 陈世益, 冯华. 现代骨科运动医学. 上海: 复旦大学出版社, 2020: 153-154.
10. Gerber C, Nyffeler RW. Classification of glenohumeral joint instability. Clin Orthop Relat Res, 2002, (400): 65-76.
11. Almekinders LC, Temple JD. Etiology, diagnosis, and treatment of tendonitis: an analysis of the literature. Med Sci Sports Exerc, 1998, 30(8): 1183-1190.
12. Cooper DE, Arnoczky SP, O’Brien SJ, et al. Anatomy, histology, and vascularity of the glenoid labrum. J Bone Joint Surg (Am), 1992, 74(1): 46-52.
13. Wilk KE, Andrews JR, Arrigo CA. The physical examination of the glenohumeral joint: emphasis on the stabilizing structures. J Orthop Sports Phys Ther, 1997, 25(6): 380-389.
14. Wilk KE, Arrigo CA, Andrews JR. Current concepts: the stabilizing structures of the glenohumeral joint. J Orthop Sports Phys Ther, 1997, 25(6): 364-379.
15. Rowe CR, Zarins B. Recurrent transient subluxation of the shoulder. J Bone Joint Surg (Am), 1981, 63(6): 863-872.
16. Van Blarcum GS, Svoboda SJ. Glenohumeral instability related to special conditions: SLAP tears, pan-labral tears, and multidirectional instability. Sports Med Arthrosc Rev, 2017, 25(3): e12-e17.
17. Marco SM, Lafuente JLÁ, Ibán MAR, et al. Controversies in the surgical management of shoulder instability: associated soft tissue procedures. Open Orthop J, 2017, 11: 989-1000.
18. Tokish JM, McBratney CM, Solomon DJ, et al. Arthroscopic repair of circumferential lesions of the glenoid labrum. J Bone Joint Surg (Am), 2009, 91(12): 2795-2802.
19. Yiannakopoulos CK, Mataragas E, Antonogiannakis E. A comparison of the spectrum of intra-articular lesions in acute and chronic anterior shoulder instability. Arthroscopy, 2007, 23: 985-990.
20. Kim SH, Ha KI, Choi HJ. Results of arthroscopic treatment of superior labral lesions. J Bone Joint Surg (Am), 2002, 84(6): 981-985.
21. Ide J, Maeda S, Takagi K. Sports activity after arthroscopic superior labral repair using suture anchors in overhead-throwing athletes. Am J Sports Med, 2005, 33(4): 507-514.
22. Maffet MW, Gartsman GM, Moseley B. Superior labrum-biceps tendon complex lesions of the shoulder. Am J Sports Med, 1995, 23(1): 93-98.
23. Morgan CD, Burkhart SS, Palmeri M, et al. Type Ⅱ SLAP lesions: three subtypes and their relationships to superior instability and rotator cuff tears. Arthroscopy, 1998, 14(6): 553-565.
24. Boileau P, Parratte S, Chuinard C, et al. Arthroscopic treatment of isolated type Ⅱ SLAP lesions: Biceps tenodesis as an alternative to reinsertion. Am J Sports Med, 2009, 37(5): 929-936.
25. Musgrave DS, Rodosky MW. SLAP lesions: current concepts. Am J Orthop (Belle Mead NJ), 2001, 30(1): 29-38.
26. 徐文杰, 刘沛东, 张城铭, 等. 肩关节SLAP损伤机制与治疗的研究进展. 实用骨科杂志, 2021, 27(4): 335-340.
27. Snyder SJ, Karzel RP, Del Pizzo W, et al. SLAP lesions of the shoulder. Arthroscopy, 1990, 6(4): 274-279.
28. Handelberg F, Willems S, Shahabpour M, et al. SLAP lesions: a retrospective multicenter study. Arthroscopy, 1998, 14(8): 856-862.
29. Feng S, Song Y, Li H, et al. Outcomes for arthroscopic repair of combined Bankart/SLAP lesions in the treatment of anterior shoulder instability: a systematic review and meta-analysis. Orthop J Sports Med, 2019, 7(10): 2325967119877804. doi: 10.1177/2325967119877804.
30. Powell SE, Nord KD, Ryu RKN. The diagnosis, classification, and treatment of SLAP lesions. Oper Tech Sports Med, 2004, 12: 99-110.
31. Sheean AJ, Arner JW, Bradley JP. Posterior glenohumeral instability: diagnosis and management. Arthroscopy, 2020, 36(10): 2580-2582.
32. Kandeel AA. Type Ⅴ superior labral anterior-posterior (SLAP) lesion in recurrent anterior glenohumeral instability. J Shoulder Elbow Surg, 2020, 29(1): 95-103.
33. Hantes ME, Venouziou AI, Liantsis AK, et al. Arthroscopic repair for chronic anterior shoulder instability: a comparative study between patients with Bankart lesions and patients with combined Bankart and superior labral anterior posterior lesions. Am J Sports Med, 2009, 37(6): 1093-1098.
34. Burkhart SS, Morgan C. SLAP lesions in the overhead athlete. Orthop Clin North Am, 2001, 32(3): 431-441.
35. Cho H, Lee C, Hwang T, et al. Arthroscopic repair of combined Bankart and SLAP lesions: operative techniques and clinical results. Clin Orthop Surg, 2010, 2(1): 39-46.
36. Zhu M, Chen JY, Chong HC, et al. Comparative study on clinical results of arthroscopic repair of anteroinferior, superior, and combined glenoid labral tear. J Orthop Surg (Hong Kong), 2018, 26(1): 2309499018762619. doi: 10.1016/j.arthro.2017.08.081.
37. Durban CM, Kim JK, Kim SH, et al. Anterior shoulder instability with concomitant superior labrum from anterior to posterior (SLAP) lesion compared to anterior instability without SLAP lesion. Clin Orthop Surg, 2016, 8(2): 168-174.
38. Kim DS, Yi CH, Yoon YS. Arthroscopic repair for combined Bankart and superior labral anterior posterior lesions: a comparative study between primary and recurrent anterior dislocation in the shoulder. Int Orthop, 2011, 35(8): 1187-1195.
39. Owens BD, Nelson BJ, Deberardino TM. Arthroscopic repair of combined labral lesions. Tech Shoulder Elbow Surg, 2008, 9: 10-14.
40. Ogul H, Ayyildiz V, Pirimoglu B, et al. Magnetic resonance arthrographic demonstration of association of superior labrum anterior and posterior lesions with extended anterior labral tears. J Comput Assist Tomogr, 2019, 43(1): 51-60.
41. Özer M, Kaptan AY, Ataoglu MB, et al. The Buford complex: prevalence and relationship with labral pathologies. J Shoulder Elbow Surg, 2021, 30(6): 1356-1361.
42. Schultz KA, Nelson R. Superior labrum lesions [M/OL]. Treasure Island: StatPearls Publishing, 2021. https://pubmed.ncbi.nlm.nih.gov/32491594/.
43. Nishinaka N, Uehara T, Tsutsui H. Recurrent posterior dislocation of the shoulder associated with the Buford complex. J Clin Orthop Trauma, 2016, 7(1): 55-60.
44. Antonio GE, Griffith JF, Yu AB, et al. First-time shoulder dislocation: High prevalence of labral injury and age-related differences revealed by MR arthrography. J Magn Reson Imaging, 2007, 26(4): 983-991.
45. Knesek M, Skendzel JG, Dines JS, et al. Diagnosis and management of superior labral anterior posterior tears in throwing athletes. Am J Sports Med, 2013, 41(2): 444-460.
46. Kibler WB, Sciascia A. Current practice for the diagnosis of a SLAP lesion: systematic review and physician survey. Arthroscopy, 2015, 31: 2456-2469.
47. Virk MS, Arciero RA. Superior labrum anterior to posterior tears and glenohumeral instability. Instr Course Lect, 2013, 62: 501-514.
48. Rodosky MW, Harner CD, Fu FH. The role of the long head of the biceps muscle and superior glenoid labrum in anterior stability of the shoulder. Am J Sports Med, 1994, 22(1): 121-130.
49. McMahon PJ, Burkart A, Musahl V, et al. Glenohumeral translations are increased after a type Ⅱ superior labrum anterior-posterior lesion: a cadaveric study of severity of passive stabilizer injury. J Shoulder Elbow Surg, 2004, 13(1): 39-44.
50. Pagnani MJ, Deng XH, Warren RF, et al. Effect of lesions of the superior portion of the glenoid labrum on glenohumeral translation. J Bone Joint Surg (Am), 1995, 77(7): 1003-1010.
51. Burkart A, Debski R, Musahl V, et al. Glenohumeral translations are only partially restored after repair of a simulated type Ⅱ superior labral lesion. Am J Sports Med, 2003, 31(1): 56-63.
52. Strauss EJ, Salata MJ, Sershon RA, et al. Role of the superior labrum after biceps tenodesis in glenohumeral stability. J Shoulder Elbow Surg, 2014, 23(4): 485-491.
53. Burkhart SS, Morgan CD. The peel-back mechanism: its role in producing and extending posterior type Ⅱ SLAP lesions and its effect on SLAP repair rehabilitation. Arthroscopy, 1998, 14(6): 637-640.
54. Mihata T, Lee Y, Mcgarry MH, et al. Excessive humeral external rotation results in increased shoulder laxity. Am J Sports Med, 2004, 32(5): 1278-1285.
55. Mihata T, Mcgarry MH, Tibone JE, et al. Biomechanical assessment of type Ⅱ superior labral anterior-posterior (SLAP) lesions associated with anterior shoulder capsular laxity as seen in throwers: a cadaveric study. Am J Sports Med, 2008, 36(8): 1604-1610.
56. Itoi E, Motzkin NE, Morrey BF, et al. Stabilizing function of the long head of the biceps in the hanging arm position. J Shoulder Elbow Surg, 1994, 3(3): 135-142.
57. McFarland EG, Neira CA, Gutierrez MI, et al. Clinical significance of the arthroscopic drive-through sign in shoulder surgery. Arthroscopy, 2001, 17(1): 38-43.
58. Rokito SE, Myers KR, Ryu RK. SLAP lesions in the overhead athlete. Sports Med Arthrosc Rev, 2014, 22(2): 110-116.
59. Soslowsky LJ, Malicky DM, Blasier RB. Active and passive factors in inferior glenohumeral stabilization: a biomechanical model. J Shoulder Elbow Surg, 1997, 6(4): 371-379.
60. Kim DS, Yi CH, Kwon KY, et al. Relationship between the extent of labral lesions and the frequency of glenohumeral dislocation in shoulder instability. Knee Surg Sports Traumatol Arthrosc, 2013, 21(2): 430-437.
61. Kim TK, Mcfarland EG. Internal impingement of the shoulder in flexion. Clin Orthop Relat Res, 2004, 421: 112-119.
62. Cohen DB, Coleman S, Drakos MC, et al. Outcomes of isolated type Ⅱ SLAP lesions treated with arthroscopic fixation using a bioabsorbable tack. Arthroscopy, 2006, 22(2): 136-142.
63. Habermeyer P, Gleyze P, Rickert M. Evolution of lesions of the labrum-ligament complex in posttraumatic anterior shoulder instability: a prospective study. J Shoulder Elbow Surg, 1999, 8(1): 66-74.
64. Milano G, Grasso A, Russo A, et al. Analysis of risk factors for glenoid bone defect in anterior shoulder instability. Am J Sports Med, 2011, 39(9): 1870-1876.
65. Mazzocca AD, Brown FMJ, Carreira DS, et al. Arthroscopic anterior shoulder stabilization of collision and contact athletes. Am J Sports Med, 2005, 33(1): 52-60.
66. Lo IK, Burkhart SS. Triple labral lesions: pathology and surgical repair technique-report of seven cases. Arthroscopy, 2005, 21(2): 186-193.
67. Koss S, Richmond JC, Woodward JSJ. Two- to five-year follow up of arthroscopic Bankart reconstruction using a suture anchor technique. Am J Sports Med 1997, 25(6): 809-812.
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Arthroscopic Pushlock anchor fixation with iliac creast bone autograft in the treatment of recurrent anterior shoulder instability with critical bone defect

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Research progress on the relationship between shoulder instability and superior labrum anterior posterior lesion

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