Non-SLAP lesions include degenerative, flap and vertical tears, as well as Bankart lesions
, avulsions of the anterioinferior labrum at its attachment to the inferior glenohumeral ligament (Wilk et al 2005).
First-time traumatic dislocations will result in a Bankart lesion
and Hill-Sachs lesion in more than 80% of cases.
The earliest technique of Bankart lesion
repair was the staple technique.
Although osseous injuries such as Hill-Sachs or bony Bankart lesions
may occur in first-time dislocators, patients usually report a history of recurrent dislocation.
Lastly, there is a high incidence of associated pathology and injuries with SLAP lesions, including rotator cuff disorders (partial-thickness rotator cuff tears, 40% to 29%, and full-thickness rotator cuff tears, 11%), Bankart lesions
(22%), acromioclavicular joint arthrosis (16%), and glenohumeral chondromalacia (10%).
Based on a prospective, nonrandomized comparison, they recommend arthroscopic Bankart repair for patients with isolated anterior instability and a discrete Bankart lesion
Maffet and coworkers23 added three additional types to Snyder's classification: Type V lesions involve an anteroinferior Bankart lesion
extending upward to include separation of the biceps tendon; Type VI lesions consist of an unstable radial or flap tear associated with separation of the biceps anchor; and Type VII lesions involve extension of the SLAP lesion beneath the middle glenohumeral ligament.
The absence of a Bankart lesion
was associated with a poor outcome.
Case series: Combined large Hill-Sachs and bony Bankart lesions
treated by Latarjet and partial humeral head resurfacing: a report of 2 cases.
Common injuries include Bankart lesions
(cartilaginous and osseous), Perthes lesions and anterior labral periosteal sleeve avulsions (ALPSA).
The over-40 group tends to tear their rotator cuff and younger people have Bankart lesions
, where ligaments are pulled off the glenoid.
Of note, SLAP tears are associated with additional shoulder pathology in 88% of cases (17) with an association with Bankart lesions
in patients younger than 40 years and an association with supraspinatus tears in those older than 40 years.
Identification of predisposing factors such as age (Hovelius et al, 2008), size of Bankart lesions
(Rhee and Lim, 2007) or size of Hill Sachs lesions (Kralinger et al, 2002) may be one way that could aid in determining the patient's risk of re-dislocation.