Anterior Rotator Interval Lesion (ARIL), its association with glenoid labrum pathology in patients with anterior shoulder pain and surgical outcome of Arthroscopic Rotator Interval Closure (ARIC)

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma Pub Date : 2024-11-01 DOI:10.1016/j.jcot.2024.102796

Mohit J. Jain , Giovanna Medina , Aashish V. Jog , Arthur R. Bartolozzi , Craig Morgan

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引用次数: 0

Abstract

Background

Anterior rotator interval lesions (ARIL) have been associated with shoulder instability. However, a paucity of data exists on its association with labrum pathology as a source for persistent anterior shoulder pain. This study primarily aims to describe pathoanatomy of ARIL and the parameters we used that aid in the diagnosis of ARIL. Secondly, the objective is to describe and report the prevalence of ARIL in combination with labrum injuries presenting as anterior shoulder pain with mild or no instability. Lastly, we intend to present a cohort of patients with combined labrum injury and ARIL and report on the clinical results after labrum repair with Arthroscopic Rotator Interval Closure (ARIC).

Methods

Consecutive patients at a single center in United States treated for labrum tears were included by retrospective chart-review. Patients presenting with anterior shoulder pain with mild or no instability were included. Patients with recurrent dislocations, moderate to severe instability and those with bony lesions were excluded. Besides history and physical examination, Magnetic Resonance Arthrography (MRA) was used to aid the diagnosis. Labrum tears with ARIL were treated with an additional ARIC procedure along with arthroscopic labrum repair.

Results

Out of two hundred fourty patients with a labrum tear, 114 had associated ARIL. The prevalence of ARIL ranged from 71 % with reverse Bankart tears to 46 % with anterior Bankart and 36 % in Type II SLAP tears. The success rate after labrum tear repair with ARIC performed in patients with ARIL with labrum pathology was 94.7 % at a 2-year follow-up in terms of relief from anterior shoulder pain.

Conclusion

Almost half (47.5 %) of our patients presented with anterior shoulder pain with labrum tears were associated with ARIL. We recommend keeping a high index of suspicion for ARIL in labrum injuries presenting mainly with anterior shoulder pain for better treatment planning.

Level of evidence

Level IV (Retrospective case series without a comparision group)

查看原文本刊更多论文

肩关节前部疼痛患者的旋前肌间隙病变（ARIL）、其与盂唇病变的关联以及关节镜下旋前肌间隙闭合术（ARIC）的手术效果

背景旋前肌间隙病变（ARIL）与肩关节不稳定性有关。然而，关于其与肩关节盂病变之间的关系以及肩关节前部持续疼痛来源的数据却很少。本研究的主要目的是描述 ARIL 的病理解剖，以及我们用于帮助诊断 ARIL 的参数。其次，我们的目的是描述并报告ARIL与肩关节唇损伤合并的发病率，ARIL表现为轻度或无不稳定性的肩关节前部疼痛。最后，我们打算介绍一组合并有肩关节盂损伤和 ARIL 的患者，并报告使用关节镜下旋转肌间隙闭合术（ARIC）进行肩关节盂修复后的临床效果。研究对象包括肩关节前部疼痛、轻度或无不稳定性的患者。不包括反复脱位、中度至重度不稳定以及骨质病变的患者。除病史和体格检查外，磁共振关节造影术（MRA）也用于辅助诊断。对伴有ARIL的盂唇撕裂，在进行关节镜下盂唇修复的同时，还进行了额外的ARIC手术。ARIL的发生率从反向Bankart撕裂的71%到前方Bankart撕裂的46%，以及II型SLAP撕裂的36%不等。结论在肩关节前部疼痛伴有盂唇撕裂的患者中，几乎有一半（47.5%）的患者伴有ARIL。我们建议对主要表现为肩前部疼痛的肩关节盂唇损伤高度怀疑ARIL，以制定更好的治疗计划。证据等级IV级（回顾性病例系列，无对比组）

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Orthopaedics and Trauma Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

0.00%

发文量

181

审稿时长

92 days

期刊介绍： Journal of Clinical Orthopaedics and Trauma (JCOT) aims to provide its readers with the latest clinical and basic research, and informed opinions that shape today''s orthopedic practice, thereby providing an opportunity to practice evidence-based medicine. With contributions from leading clinicians and researchers around the world, we aim to be the premier journal providing an international perspective advancing knowledge of the musculoskeletal system. JCOT publishes content of value to both general orthopedic practitioners and specialists on all aspects of musculoskeletal research, diagnoses, and treatment. We accept following types of articles: • Original articles focusing on current clinical issues. • Review articles with learning value for professionals as well as students. • Research articles providing the latest in basic biological or engineering research on musculoskeletal diseases. • Regular columns by experts discussing issues affecting the field of orthopedics. • "Symposia" devoted to a single topic offering the general reader an overview of a field, but providing the specialist current in-depth information. • Video of any orthopedic surgery which is innovative and adds to present concepts. • Articles emphasizing or demonstrating a new clinical sign in the art of patient examination is also considered for publication. Contributions from anywhere in the world are welcome and considered on their merits.