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Treatment of Labral Tears with Associated Spinoglenoid Cysts without Cyst Decompression

Schroder, Cecilie P., MD1; Skare, Oystein, PT1; Stiris, Morten, MD2; Gjengedal, Erling, MD1; Uppheim, Gisle, MD1; Brox, Jens Ivar, MD, PhD3

doi: 10.2106/JBJS.F.01534
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Background: The treatment of symptomatic spinoglenoid cysts has varied from observation, needle aspiration, and open excision to arthroscopic decompression. The purpose of the present study was to prospectively assess whether labral repair alone would lead to cyst resolution and pain relief.

Methods: Forty-two patients with a posterosuperior labral tear and a ganglion cyst at the spinoglenoid notch were treated with arthroscopic débridement of the glenoid rim and labral repair, either with a resorbable tack or a suture anchor. Patients ranged in age from twenty-three to sixty-eight years. Seven patients had clinical and/or radiographic evidence of atrophy of the infraspinatus muscle; one had atrophy of both the infraspinatus and the teres minor muscles, while two had atrophy of the teres minor muscle. All patients had postoperative magnetic resonance imaging performed twice, at an average of fifteen months and again at an average of forty-three months postoperatively. The clinical outcome, including the Rowe score, was assessed for all patients at a median of forty-three months postoperatively.

Results: In thirty-seven (88%) of the forty-two patients, the cysts had resolved completely. In five patients, a cyst was still present but with a clear reduction in size. These five patients had remission of pain and were satisfied with the shoulder function. Three patients with preoperative muscular atrophy without fatty infiltration regained normal appearing muscle, while the seven with preoperative fatty changes continued to demonstrate those changes postoperatively. The median Rowe score improved from 61.5 points preoperatively to 98.0 points at the time of follow-up. Thirty-one patients assessed the result of treatment as excellent; nine, as good; and two, as fair.

Conclusions: Most spinoglenoid cysts resolve, and patient satisfaction can be expected to be high after labral fixation without cyst decompression.

Level of Evidence: Prognostic Level IV. See Instructions to Authors for a complete description of levels of evidence.

1Department of Orthopaedic Surgery, Lovisenberg Deaconal Hospital, Lovisenberggt 17, 0440 Oslo, Norway. E-mail-address for C. Schroder: cecilie.schroder@lds.no

2Department of Radiology, Aker University Hospital, Trondheimsveien 235, 0182 Oslo, Norway

3Department of Orthopaedic Surgery, Rikshospitalet University Hospital, Sognsvannsveien 20, 0027 Oslo, Norway

Copyright © 2008 by The Journal of Bone and Joint Surgery, Incorporated
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