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ABSTRACT
An increased incidence of glenoid labral injuries has been reported, possibly due to advances in imaging procedures with an improved ability to define these injuries. This narrative review describes the common variations of the glenoid labrum, age-related changes and effects of sportand occupation-related stress. Five electronic databases were searched using the following keywords: shoulder joint, glenoid labrum, age factors and age. Thirteen articles met the inclusion criteria: seven investigated cadavers, two throwing sportspeople and four patients undergoing shoulder arthroscopy. Normal anatomical variants include the sublabral foramen and recess, a mobile superior glenoid labrum, a cord-like middle glenohumeral ligament and the Buford complex. These changes start to appear around the age of 30 years with increasing incidence with age, while in throwing sportspeople changes and SLAP lesions commonly appear as early as adolescence. Longitudinal studies are needed to confirm the development of these changes, and whether or not they are associated with risk for future symptoms. Flowever, based on current findings, the presence of the ageor activity-related changes is not always associated with symptoms. Thus, caution is needed when making decisions with regards to the labral changes as possible sources of a patient's shoulder symptoms.
Key words: age factors, ageing, glenoid labrum, shoulder joint
INTRODUCTION
Shoulder pain remains one of the most common musculoskeletal disorders seen in general practice. Various disorders or pathology may contribute towards this pain, such as subacromial impingement syndrome, rotator cuff pathology and/or lesions of the glenoid labrum (Feleus et al 2008). The glenoid labrum consists of a ring of dense collagenous tissue fibres with fibrocartilaginous tissue in the peripheral attachment area (Prescher 2000). It expands the size and depth of the glenoid cavity, increasing the stability of the glenohumeral joint (Cooper et al 1992). It also provides an attachment site for the shoulder capsule, glenohumeral ligaments and the tendon of the long head of the biceps muscle. Vascularity of the labrum is limited to the periphery, being supplied from the suprascapular, circumflex scapular, and posterior circumflex humeral arteries (Cooper et al 1992). A cadaveric study showed a small number of free nerve endings in the fibro-cartilage tissue of the peripheral half of the labrum, with no evidence for mechanoreceptors (Vangsness et al 1995).
Injuries to the glenoid labrum...