Age related morphometric changes of the glenoid labrum

Abstract

Objectives: Although the glenoid labrum is linked to glenohumeral joint stability, its anatomy remains controversial. This study aimed to investigate the shape, consistency of the glenoid labrum, and whether these and its thickness and depth are age related. Methods: A total of 140 shoulders were dissected to expose the glenoid labrum. the shape and consistency of the glenoid labrum were assessed at a gross level. Measurements were taken of the labrum depth and thickness, using callipers, in the superior, anterior, inferior and posterior regions. ANOVA and chi-square tests were conducted to determine statistical significance, which was set at p<0.05. Results: The consistency of the superior half of the labrum was rubbery in 97.9% of specimens and firm in the remaining 2.1%, whereas the entire inferior half was firm. There was a significant difference (p=0.043) in the consistency of the superior half between males and females. The superior half was triangular in 95.7% of specimens, flat in 2.1% and flat to triangular in 2.1%, whereas the shape of the inferior half was rounded in 99.3% of specimens and flat in 0.7%. The labrum was observed to be thicker in younger individuals, with the differences being significant superiorly (p=0.011), anteriorly (p=0.050), inferiorly (p=0.001) and posteriorly (p=0.047). It was also observed to be deeper in younger individuals, but only significantly so superiorly (p=0.044). Conclusion: Labrum thickness and depth significantly decreased with increasing age, suggesting that these observations could be age-related.

Keywords

• glenoid labrum
• morphometry
• scapula
• shoulder

References

1. Prodromos CC, Ferry JA, Schiller AL, Zarins B. Histological studies of the glenoid labrum from fetal life to old age. J Bone Joint Surg Am 1990;72:1344–8.
2. Park YH, Lee JY, Moon SH, Mo JH, Yang BK, Hahn SH, Resnick D. MR arthrography of the labral capsular ligamentous complex in the shoulder: imaging variations and pitfalls. AJR Am J Roentgenol 2000;175:667–672.
3. Carey J, Small CF, Pichor, DR. In situ compressive properties of the glenoid labrum. J Biomed Mater Res 2000;51:711–6.
4. Sager M, Herten M, Ruchay S, Assheuer J, Kramer M, Jäger M. The anatomy of the glenoid labrum: a comparison between human and dog. Comp Med 2009;59:465–75.
5. De Maeseneer M, Van Roy F, Lenchik L, Shahabpour M, Jacobson J, Ryu KN, Handelberg F, Osteaux M. CT and MR arthrography of the normal and pathologic anterosuperior labrum and labral-bicipital complex. Radiographics 2000;20:S67–81.
6. Cooper DE, Arnoczky SP, O'Brien SJ, Warren RF, DiCarlo E, Allen AA. Anatomy, histology, and vascularity of the glenoid labrum. An anatomical study. J Bone Joint Surg Am 1992;74:46–52.
7. Haynor DR, Shuman WP. Double contrast CT arthrography of the glenoid labrum and shoulder girdle. RadioGraphics 1984;4:411–21.
8. Rafii M. Non-contrast MR imaging of the glenohumeral joint. Part I. Normal anatomy. Skeletal Radiol 2004;33:551–60.

9. Smith JW, Murphy TR, Blair JSG, Lowe KG. Regional anatomy illustrated. Edinburgh: Churchill Livingstone; 1983.
10. Soames R, Palastanga N. Anatomy and human movement: structure and function. 7th ed. Edinburgh: Elsevier; 2018. 593 p.
11. Howell SM, Galinat BJ. The glenoid-labral socket. A constrained articular surface. Clin Orthop Rel Res 1989;(243):122–5.
12. Lippitt S, Matsen F. Mechanisms of glenohumeral joint stability. Clin Orthop Rel Res 1993;(291):20–8.
13. Halder AM, Kuhl SG, Zobitz ME, Larson D, An KN. Effects of the glenoid labrum and glenohumeral abduction on stability of the shoulder joint through concavity-compression: an in vitro study. J Bone Joint Surg Am 2001;83:1062–9.
14. Robinson A. Cunningham’s textbook of anatomy. London: Henry Frowde Hodder & Stoughton; 1992.
15. Greis, PE, Scuderi, MG, Mohr A, Bachus, KN, Burks, RT. Glenohumeral articular contact areas and pressures following labral and osseous injury to the anteroinferior quadrant of the glenoid. J Shoulder Elbow Surg 2002;11:442–51.
16. Pfahler M, Haraida S, Schulz C, Anetzberger H, Refior HJ, Bauer GS, Bigliani LU. Age-related changes of the glenoid labrum in normal shoulders. J Bone Joint Surg 2003;12:40–52.
17. Drury NJ, Ellis BJ, Weiss JA, McMahon PJ, Debski RE. The impact of glenoid labrum thickness and modulus on labrum and glenohumeral capsule function. J Biomech Eng 2010;132:121003.
18. Hata Y, Nakatsuchi Y, Saitoh S, Hosaka M, Uchiyama S. Anatomic study of the glenoid labrum. J Shoulder Elbow Surg 1992;1:207–14.
19. Alashkham A, Alraddadi A, Soames R, Morphometric parameters of the glenoid labrum. European Journal of Anatomy 2019;23:41–7.
20. Smith CD, Masouros SD, Hill AM, Wallace AL, Amis AA, Bull AM. Tensile properties of the human glenoid labrum. J Anat 2008;212: 49–54.
21. McNiesh LM, Callaghan JJ. CT arthrography of the shoulder: variations of the glenoid labrum. AJR Am J Roentgenol 1987;149:963–6.
22. Longo C, Loredo R, Yu J, Salonen D, Haghighi P, Trudell D, Clopton P, Resnick D. Pictorial essay. MRI of the glenoid labrum with gross anatomic correlation. J Comput Assist Tomogr 1996;20:487–95.