My Orthopaedic Surgeon

The glenoid labrum is a triangular fibrocartilaginous structure that serves to deepen the glenoid. While tears of the anteroinferior labrum have long been known to be associated with significant shoulder pathology, injuries of the superior labrum have really only been appreciated as a potential pathological lesion since the advent of shoulder arthroscopy. The superior labrum often has a more meniscoid attachment to the glenoid rim compared with the remainder of the labrum and therefore may be more susceptible to both degenerative as well as traumatic lesions. It also serves as part of the origin of the long head of the biceps. Injuries to the superior labral biceps complex can compromise the biceps anchor. Furthermore, the repetitive tensile force exerted by the biceps on the superior labrum likely contributes to poor healing of superior labral tears.
Synonyms and related keywords: glenoid labrum, tears of the anteroinferior labrum, shoulder pathology, SLAP lesion, superior labrum anterior and posterior lesion, shoulder injury, throwing injury, dead arm syndrome, O'Brien sign, O'Brien's sign, active-compression test, peel-back phenomena, peel-back sign, Buford complex, Buford's complex, Jobe relocation test, dead arm syndrome, drive-through sign
Author: S Ashfaq Hasan, MD 2006

Before the use of shoulder arthroscopy and magnetic resonance imaging (MRI) in the diagnosis and management of shoulder problems, glenoid labrum lesions were underappreciated. More specifically, superior labrum lesions about the insertion of the long biceps tendon were typically were noted or managed using standard open surgical techniques. An improved understanding of the surgical anatomy and the biomechanical contributions of the superior labrum have demonstrated its significance in shoulder stability and its role in the pathogenesis of shoulder pain. Andrews et al published a study that examined glenoid labrum lesions related to the long head of the biceps (LHB) in 73 throwing athletes.1 The authors observed that the LHB was contiguous with the superior labrum and that most of these patients had avulsed the anterosuperior labrum off the glenoid in conjunction with the biceps tendon. Subsequently, Snyder et al defined the pattern of superior labral injury in 27 patients who were described as having superior labrum anterior posterior (SLAP) lesions.
Synonyms and related keywords: superior labrum anterior-posterior lesion, SLAP lesion, superior glenoid lesion, anterior to posterior lesion of the superior labrum, anterior-to-posterior lesion of the superior labrum, shoulder instability, labral repair, posterior labral repair, capsulolabral complex, capsulolabral repair, Bankart lesion, Buford complex
Williams & Petrigliano 2008