“Down Under” glenoid labral tears

Anterior shoulder dislocations are a common injury. My website describes the typical labral tear that involves the front lower quadrant of the shoulder socket (the glenoid). This month we published a research article on a variant of these labral tears1. Professor Page led the research team and looked at inferior labral tears. These are tears that involve the lower quadrant of the glenoid and extend from front to back. They have been termed “Down Under” lesions.

This subgroup of inferior labral tears was infrequent. However, they were more frequently associated with a family history of shoulder dislocations. Also, the arm was generally overhead at the time of the injury. Therefore, we postulate that some of these injuries were caused by a downward force on the raised arm. This, in turn, could create a shearing force to the lower part of the labrum, leading to the “Down Under” lesion.

These inferior lesions were difficult to diagnose on MRI scans, the usual “Gold standard” for detecting shoulder labral tears. However, most patients reported good outcomes with arthroscopic repair.

  1. Richard Page et al. “Arthroscopic repair of inferior glenoid labrum tears (Down Under lesions) produces similar outcomes to other glenoid tears.” Knee Surgery, Sports Traumatology, Arthroscopyhttps://doi.org/10.1007/s00167-021-06702-9