Shoulder posteroinferior labral tears typically refer to tears in the labrum of the shoulder joint that occur towards the back and lower part of the socket (glenoid). The labrum is a cartilage ring that surrounds the glenoid and helps stabilise the shoulder joint.
Here are some key points about shoulder posteroinferior labral tears:
- Location: These tears occur in the posterior (back) and inferior (lower) part of the labrum. This area is particularly susceptible to injury due to the mechanics of certain shoulder movements and positions.
Normal Glenoid Labrum Anatomy:
The arrow shows the area of the posteroinferior labral tear:
This is an arthroscopic view from the anterosuperior portal looking into the posteroinferior labrum of a RIGHT shoulder. It shows a posteroinferior labral tear.
- Causes: Tears in this area can result from trauma, such as a fall onto an outstretched arm, or repetitive overhead activities (common in athletes such as baseball pitchers or volleyball players).
- Symptoms: Symptoms may include pain in the back of the shoulder that worsens with certain movements or positions, a sensation of catching or locking in the shoulder, and sometimes shoulder instability.
- Diagnosis: Diagnosis is typically made through a combination of clinical examination, imaging studies (such as MRI), and sometimes diagnostic arthroscopy (a procedure where a small camera is inserted into the shoulder joint).
An MRI scan of the painful shoulder can help to show the posterior labral tear. In this case, a clear separation of the posterior labrum from the bony glenoid is clearly visible on the scan.
In some cases, the presence of paralabral cyst can help to make a diagnosis of a labral tear.
- Treatment: Treatment depends on the severity of the tear and the patient’s symptoms. It may range from conservative measures such as rest, physical therapy, and anti-inflammatory medications, to surgical repair in cases where conservative measures do not provide relief or for more severe tears.
Surgery is usually needed to treat posterior labral tears when conservative management fails. The surgery involves an arthroscopic examination of the painful shoulder to demonstrate the tear followed by arthroscopic repair of the torn labrum back to bone.
Arthroscopic finding of a torn posterior inferior labral tear:
The torn posterior labrum is mobilised and the bone bed rasped to encourage bleeding:
The torn labrum is repaired back to bone using knotless anchors:
The posterior labrum has been repaired back to bone successfully:
- Rehabilitation: Rehabilitation after surgery or during conservative treatment is crucial to restore strength and range of motion in the shoulder. Physical therapy plays a key role in this process.
