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. 2020 Mar 30;8(3):2325967120907892.
doi: 10.1177/2325967120907892. eCollection 2020 Mar.

Glenoidplasty With Posterior Labral Reattachment for Posterosuperior Glenoid Impingement

Geoffroy Nourissat  1 , Julien Provost  1 , Marie Vigan  1 , Claire Cammas  1
Affiliations

Glenoidplasty With Posterior Labral Reattachment for Posterosuperior Glenoid Impingement

Geoffroy Nourissat et al. Orthop J Sports Med. .

Abstract

Background: Posterosuperior glenoid impingement (PSGI), also known as shoulder internal impingement, is a cause of shoulder pain in athletes involved in overhead-throwing sports. PSGI is a condition mostly treated by rehabilitation. Surgery is indicated after unsatisfactory nonoperative management. However, with most of the surgical techniques proposed, the shoulder remains persistently painful during sport activity.

Hypothesis: We aimed to evaluate the efficiency of adding posterior labral reattachment to glenoidplasty as a surgical treatment for PSGI. Our hypothesis was that posterior labral reattachment would have a positive effect on shoulder pain. To our knowledge, this combined procedure has not been previously described.

Study design: Case series; Level of evidence, 4.

Methods: We retrospectively reviewed 11 male patients with PSGI treated with glenoidplasty and posterior labral reattachment at a single institution during a 7-year period and with a minimum 30-month follow-up after surgery. Most patients were recreational athletes, with 5 of them practicing at the national level and 1 being a professional athlete. Patients completed an online questionnaire consisting of the Simple Shoulder Test (SST), the Kerlan-Jobe Orthopaedic Clinic (KJOC) shoulder and elbow questionnaire, and a specific PSGI survey. Pre- and postoperative shoulder pain were analyzed using the paired t test, with significance set at P < .05.

Results: All 11 patients investigated sought surgery because of persistent shoulder pain while practicing their sport. The patients underwent glenoidplasty and posterior labral fixation, and data for 9 patients were available for analysis (mean age, 29 years; range, 24-42 years). At a minimum 30-month follow-up, most patients (77.8%) showed decreased pain, and 8 patients were able to return to their previous sports activities, with 7 returning at the same or higher level. There was 1 patient who had to change sports because of a lack of force, while a second patient temporarily changed sport and then returned to his sport but at an inferior level. Pre- and postoperative pain differed significantly (P < .05). Surgery did not impair daily life in all patients.

Conclusion: Glenoidplasty associated with posterior labral reattachment significantly diminished shoulder pain in athletes involved in throwing sports. Most patients were able to return to their previous sport at the same or higher level. Posterior labral fixation may improve the benefit of glenoidplasty by decreasing pain.

Keywords: arthroscopic treatment; debridement; glenoidplasty; overhead-throwing athletes; posterosuperior glenoid impingement; shoulder pain; surgery; labral reattachment; sport.

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Conflict of interest statement

The authors declared that there are no conflicts of interest in the authorship and publication of this contribution. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

Figures

Figure 1.
Figure 1.
Partial tear of the deep supraspinatus tendon insertion.
Figure 2.
Figure 2.
Patient 1: Posterior labral lesion (flap).
Figure 3.
Figure 3.
Patient 1: Lesion assessment.
Figure 4.
Figure 4.
Patient 1: Mechanical release of the labral lesion.
Figure 5.
Figure 5.
Patient 1: Glenoidplasty performed with a motorized shaver to enhance biological healing.
Figure 6.
Figure 6.
Patient 2: Spur evaluation and removal with a motorized shaver.
Figure 7.
Figure 7.
Patient 1: LUPINE Loop Anchor fixation.
Figure 8.
Figure 8.
Patient 1: Labral reattachment (using sutures).
Figure 9.
Figure 9.
Boxplot comparison between pre- and postoperative pain.
See this image and copyright information in PMC

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