Shoulder arthroscopy: its role in evaluating shoulder disorders in the athlete

Abstract

We retrospectively reviewed 100 initial shoulder ar throscopies from a general sports medicine orthopaedic practice to determine if arthroscopy is helpful diagnos tically and to see if specific lesions correlate well with specific diagnoses. Seventy-two percent of the patients in the review had glenoid labral tears. Ninety-two per cent of patients who had a diagnosis of either recurrent anterior dislocation or recurrent anterior subluxation demonstrated a tear of the anterior inferior margin of the glenoid labrum. Sixty-eight percent of patients with a diagnosis of impingement demonstrated tears at the superior margin of the labrum. There was a significant difference between throwing and nonthrowing athletes. Partial rotator cuff tears were noted in 18 patients, the majority occurring in throwing athletes. Other abnor malities, such as degenerative joint changes and biceps tendon lesions, were also noted at the time of arthros copy. A large number of glenoid labral tears found at the time of arthroscopy appeared to be associated with conditions other than instability, which may or may not affect the throwing athlete. There also appeared to be a high correlation between tears in the anterior inferior glenoid labrum and anterior instability. Arthroscopy en abled us to identify other significant information about the status of the biceps tendon or the undersurface of the rotator cuff. These are areas in which problems might otherwise have been missed. Degenerative changes of the articular surface, not apparent on plain radiographs, may also be better evaluated arthroscop ically.