The MRA was obtained after a three-month wait (Figure 2), and indicated the following: moderate hypertrophic degenerative arthropathy of the acromioclavicular joint; mild narrowing of the supraspinatus outlet; mild subacromial/subdeltoid bursitis; humeral avulsion of the inferior glenohumeral ligament; no Hill-Sachs fracture or osseous Bankart fracture.
Further to this, Bigliani (16) showed that three failure sites exist for the components of the inferior glenohumeral ligament complex: glenoid insertion (40%), ligament midsubstance (35%), and humeral insertion (25%).
Non-SLAP lesions include degenerative, flap and vertical tears, as well as Bankart lesions, avulsions of the anterioinferior labrum at its attachment to the inferior glenohumeral ligament
(Wilk et al 2005).
Savoie III, "Humeral and glenoid detachment of the anterior inferior glenohumeral ligament
: a cause of anterior shoulder instability," Journal of Shoulder and Elbow Surgery, vol.
Two double-loaded 4.5 mm screw-in suture anchors were then placed, and the inferior glenohumeral ligament
and overlying subscapularis were repaired using modified Mason-Allen stitches (Fig.
External rotation greater than 90[degrees] at the side is suggestive of anterior ligamentous hyperlaxity; asymmetrical hyperabduction of more than 20[degrees] compared to the contralateral arm is indicative of a stretched inferior glenohumeral ligament
Humeral avulsion of glenohumeral ligaments
(HAGL) lesions are another known cause of anterior shoulder instability.
The contribution of the glenohumeral ligaments
to anterior stability of the shoulder.
(16) As stated previously, the sublabral foramen is considered a normal anatomic variant and the shoulder joint functions appropriately in the presence of such a defect given that the glenohumeral ligaments
and rotator cuff muscles are intact.
Normally, external rotation of the humerus creates tension in the glenohumeral ligaments
, especially the inferior glenohumeral ligament
Bencardino and colleagues (24) found that SLAP lesions were associated with partial rotator cuff tears in 42% of patients, frayed or lax inferior glenohumeral ligaments
in 26%, Bankart lesions in 16%, Hill-Sachs lesions in 16%, chondral lesions in 16%, loose bodies in 10%, complete rotator cuff tears in 5%, and posterior labral tears in 5%.
(9,18-21) Humeral avulsion of the glenohumeral ligament
occurs more infrequently, but is also associated with high rates of recurrent instability.