Mobile superior glenoid labrum - A normal variant or pathologic condition?

Background: Arthroscopic differentiation between a pathologic superior labrum anterior posterior lesion and a normal anatomic variant may be difficult. Hypothesis: Various anatomic patterns exist that systematically characterize superior biceps-labral configurations. One variant involves a mobile superior labrum with exposed articular cartilage on the superior glenoid tubercle. The authors seek to demonstrate that this is nonpathologic. Study Design: A prospective, consecutive descriptive anatomic study with 1-year clinical follow-up of a subgroup with an identified mobile superior labrum. Methods: A total of 191 consecutive patients were prospectively evaluated arthroscopically to quantify the dimensions of the labrum and articular cartilage on the supraglenoid tubercle. Results: A subgroup of 49 patients was identified with articular cartilage on the supraglenoid tubercle, a mobile labrum, and no fibrous tearing or evident injury in this region. In postoperative follow-up, only 1 (2.0%) of these patients was clinically symptomatic in the region of the superior labrum-biceps origin. Conclusions: Indication for repair of a mobile superior glenoid labrum must be carefully addressed in the context of normal anatomic morphologic variability. The labral and supraglenoid tubercle morphology was noted to be highly variable. Clinical Relevance: Patients with mobile labral tissue overlying intact articular cartilage, and no evidence of trauma, are not candidates for repair.