Anterosuperior Labral Tear Without Biceps Anchor Involvement: A Subtle Isolated Cause of a Painful Shoulder

Purpose: The purposes of this study were to determine common clinical symptoms related to an anterosuperior labral tear without biceps anchor involvement and to establish the outcome of arthroscopic management of this injury. Methods: In our database of arthroscopic procedures we identified 23 patients with an isolated anterosuperior labral tear. The mean age at the time of surgery was 38.3 +/- 6.8 years (range, 18 to 59 years). The preoperative clinical diagnosis varied, but an anterosuperior labral isolated lesion was not detected before surgery. The diagnosis of anterosuperior labral tear was made arthroscopically, and the lesion was fixed with a suture anchor technique, by use of 1 single bioabsorbable anchor. Patients were reviewed after a minimum of 2.5 years of follow-up. Clinical outcome was evaluated with the Rowe score, American Shoulder and Elbow Surgeons score, Simple Shoulder Test score, and visual analog scale score. Results: History, clinical examination, and preoperative imaging usually failed to indicate the presence of an isolated anterosuperior labral tear as the cause of shoulder pain in our patients. Repair of the labral lesions yielded good to excellent results with normalization of the range of motion and a significant improvement in shoulder scores (Rowe, American Shoulder and Elbow Surgeons, Simple Shoulder Test, and visual analog scale). Conclusions: Isolated tears of the anterosuperior labrum represent a subtle cause of shoulder pain and dysfunction. The lesion is very difficult to diagnose clinically. Arthroscopic repair is a reliable procedure providing a good outcome in terms of pain relief, patient satisfaction, and shoulder scores. Level of Evidence: Level IV, therapeutic case series.