The middle glenohumeral ligament: a classification based on arthroscopic evaluation

Area of Science:

• Orthopedic Surgery
• Anatomy
• Sports Medicine

Background:

• Variations in the middle glenohumeral ligament (MGHL) are documented but their clinical significance and association with intra-articular pathologies, apart from the Buford complex, remain unclear.
• Understanding MGHL variations is crucial for diagnosing and treating shoulder pathologies.

Purpose of the Study:

• To classify middle glenohumeral ligament (MGHL) variations.
• To investigate the relationship between MGHL types and common intra-articular shoulder pathologies, including SLAP lesions, subscapularis tears, and anterior instability.

Main Methods:

• Retrospective analysis of 843 shoulder arthroscopies.
• Development of a classification system for MGHL based on structure and labral relationship.
• Statistical analysis to determine associations between MGHL types and clinical pathologies.

Main Results:

• A novel 6-type classification system for MGHL variations was established.
• Type 6 MGHL (Buford complex) showed a significant association with superior labrum anterior-posterior (SLAP) lesions (P < .001).
• No significant differences were found between MGHL types and anterior instability history (P = .131) or subscapularis tears (P = .324).

Conclusions:

• Type 6 MGHL, or the Buford complex, is significantly more prevalent in patients with SLAP lesions.
• Thicker variants of the MGHL appear to have a negative correlation with anterior instability.