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First published on May 22, 2007, doi:10.1177/0363546507302546
This version was published on September 1, 2007
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The American Journal of Sports Medicine 35:1477-1483 (2007)
© 2007 American Orthopaedic Society for Sports Medicine

Arthroscopic Capsulolabral Reconstruction of the Type VIII Superior Labrum Anterior Posterior Lesion

Mean 2-Year Follow-up on 13 Shoulders

Shane Seroyer, MD*, Samir G. Tejwani, MD*,{dagger} and James P. Bradley, MD{ddagger}

From the * University of Pittsburgh, Center for Sports Medicine, Pittsburgh, Pennsylvania, and {ddagger} Burke and Bradley Orthopaedics, Pittsburgh, Pennsylvania

{dagger} Address correspondence to Samir G. Tejwani, MD, UPMC Center For Sports Medicine, 3200 S. Water St, Pittsburgh, PA 15203 (e-mail: samtejwani{at}yahoo.com).

Background: A type VIII superior labrum anterior posterior lesion represents pathologic posteroinferior extension of a type II superior labrum anterior posterior lesion with injury to the insertion of the posterior band of the inferior glenohumeral ligament. No reports in the literature describe arthroscopic treatment of a type VIII superior labrum anterior posterior lesion and its associated glenohumeral instability.

Hypothesis: Arthroscopic capsulolabral reconstruction is effective in alleviating pain and restoring stability and function in athletes with glenohumeral instability due to the type VIII superior labrum anterior posterior lesion.

Study Design: Case series; Level of evidence, 4.

Methods: From 2003 to 2006, 23 shoulders in 23 athletes were diagnosed with a type VIII superior labrum anterior posterior lesion by physical examination, magnetic resonance arthrography, and arthroscopy. All were treated with an arthroscopic capsulolabral reconstruction. Ten patients were involved in rehabilitation less than 9 months after surgery and were not included in this study. Thirteen remaining shoulders in 13 athletes with a mean age of 27.8 ± 10.9 years were analyzed at a mean follow-up of 24 months. Shoulders were evaluated preoperatively and postoperatively using the American Shoulder and Elbow Surgeons scoring system and standard subjective scales for stability, strength, function, and range of motion.

Results: Athletes most commonly participated in sport at the recreational level (n = 8), followed by collegiate (n = 3) and high school (n = 2). The most common activity was weight lifting (n = 4). Eight athletes (62%) participated in contact sports, most commonly football and wrestling. Two patients (15%) had a partial-thickness articular-sided supraspinatus tendon tear that was debrided at the time of surgery. Mean American Shoulder and Elbow Surgeons score improved from 51.4 to 90.0 (P < .001). There were significant improvements in stability, pain, function, and range of motion based on standardized subjective scales (P < .001). No shoulder required revision surgery for recurrent instability. All patients were able to return to sports, with 9 (69%) able to return to their highest level before surgery.

Conclusion: Arthroscopic capsulolabral reconstruction is an effective and reliable treatment for glenohumeral instability due to a type VIII superior labrum anterior posterior lesion in the contact, noncontact, and throwing athlete. Successful postoperative return to sport is a reasonable expectation.

Key Words: superior labrum anterior posterior (SLAP) lesion • posterior labrum • type VIII • capsulolabral reconstruction






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