Variants of the anterosuperior glenoid labrum and associated pathology

Purpose: The study goal was to determine the incidence of the sublabral foramen and the Buford complex and to assess their association with superior labral pathology. Type Of Study: Prospective case series. Methods: The surgical findings of 108 consecutive shoulder arthroscopies performed by the same surgeon were collected, along with patient demographics. During surgery, special attention was directed towards the anterosuperior labrum. The presence of a sublabral foramen or Buford complex was correlated with the morphology of the superior, middle, and inferior glenohumeral ligaments and the presence of superior labral pathology. Results: A total of 20 shoulders (18.5%) were found to have a sublabral foramen, and 7 (6.5%) had the Buford complex. The incidence of significant SLAP lesions was significantly higher in these 27 shoulders than in the rest of the study population (56% v 12%, P < .005). A thick, cord-like middle glenohumeral ligament was significantly associated with the presence of a sublabral foramen (P < .005). Conclusions: The sublabral foramen and the Buford complex may be more common than previously thought. Furthermore, these variants of anterosuperior glenoid labrum anatomy appear to be associated with superior labral pathology. The presence of a cord-like middle glenohumeral ligament is associated with a sublabral foramen variant as well as the Buford complex.