Titre du document / Document title
Quantifying the extent of a type II SLAP lesion required to cause peel-back of the glenoid labmm- : A cadaveric study
Auteur(s) / Author(s)
SENEVIRATNE Aruna (1) ;
MONTGOMERY Kenneth (1) ;
BEVILACQUA Babette (1) ;
ZIKRIA Bashir (1) ;
Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)
(1) Department of Orthopaedic Surgery, Lenox Hill Hospital, New York, New York, ETATS-UNIS
Résumé / Abstract
Purpose: To quantify the extent of labral disruption required to cause it to peel back when the peel-back test is performed. Methods: Ten cadaveric shoulders were prepared by removal of the deltoid and rotator cuff muscles. The glenohumeral joint was concentrically reduced and brought into 90° abduction and maximal external rotation. The peel-back of the labrum was graded 0, 1, or 2. The labrum was sequentially detached from the glenoid in the following order: biceps anchor only, 1 o'clock, 2 o'clock, 11 o'clock, and 3 o'clock positions. After each labral cut, the peel-back test was performed. Labral repair was performed with a single suture anchor placed at the 12:30 o'clock position; labral peel-back was reassessed. Results: A progressive increase was noted in peel-back grade with sequential cutting of the labrum posteriorly. However, disruption of the anchor alone did not lead to a positive peel-back sign. Disruption to the 2 o'clock position resulted in a positive peel-back sign overall in 9 of 10 shoulders (5 were grade 1, and 4 were grade 2). No increase was seen in peel-back grade with anterior extension of the labral detachment. Labral repair with a single anchor placed at the 12:30 o'clock position eliminated labral peel-back in 100% of shoulders. Conclusions: Detachment of the biceps anchor alone does not cause peel-back. The labrum must be disrupted to at least the 2 o'clock position before overt (grade 2) peel-back is observed. A single suture anchor placed at 12:30 o'clock eliminated peel-back of the labrum. Clinical Relevance: Validation of the peel-back test as an important diagnostic tool during shoulder arthroscopy.
Revue / Journal Title
Arthroscopy
ISSN
0749-8063
CODEN ARTHE3
Source / Source
2006, vol. 22, n
o11, pp. 1163-1167 [5 page(s) (article)] (10 ref.)
Langue / Language
Anglais
Editeur / Publisher
Elsevier, New York, NY, ETATS-UNIS
(1985)
(Revue)
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Localisation / Location
INIST-CNRS, Cote INIST : 20604, 35400015890818.0050
Nº notice refdoc (ud4) : 18288586
