Pfahler, M; Haraida, S; Schulz, C; Anetzberger, H; Refior, HJ; Bauer, GS; Bigliani, LU
Age-related changes of the glenoid labrum in normal shoulders.
A growing number of labral changes are described in the literature. The purpose of this study was to evaluate the glenoid and labrum of normal shoulders at different ages and characterize any apparent age-dependent changes. We analyzed 32 normal cadaveric shoulders with a mean age of 57 years (range, 18-89 years). There were 22 male and 10 female cadavers, with 14 right and 18 left specimens. The shoulders were studied macroscopically, histologically, and radiologically. The radiologic evaluation consisted of an analysis of the subchondral mineralization of the glenoid with the use of computed tomographic osteoabsorptiometry. Macroscopically, there were no statistically significant differences among the age groups. Histopathologically, the labrum showed a significant qualitative and quantitative increase (P<.01) in lesions across all regions with increasing age. In younger individuals, lesions at the 12-o'clock position were the most prevalent, with the incidence increasing with age. The anterosuperior position was the region with the next highest prevalence. This was also the area of the highest stress distribution on the glenoid. Our studies demonstrated clear histopathologic changes of the glenoid labrum that are significantly age-related at specific sites. The earliest changes are seen close to the area of highest stress distribution of the glenoid, which could explain the progressive labral changes with increasing age. Arthroscopically detected changes of the glenoid labrum should be evaluated in the context of age-related changes in normal shoulders.