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Glenolabral articular disruption (GLAD)
14%
171/1210
Humeral avulsion of the glenohumeral ligament (HAGL)
60%
729/1210
Superior labrum tear from anterior and posterior (SLAP)
3%
37/1210
Anterior labro-ligamentous periosteal sleeve avulsion (ALPSA)
18%
220/1210
Partial articular-sided supraspinatus tendon avulsion (PASTA)
4%
43/1210
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Humeral avulsion of the glenohumeral ligament (HAGL) occurs when the IGHL tears away from its humeral insertion without an associated subscapular tear. The classic teaching is that HAGL lesions requires open repair of the capsule, whereas the other lesions listed are felt to be better addressed with an arthroscopic approach. According to the literature review by Stein et al., patients with significant glenoid bone loss, attenuated capsulolabral tissue, engaging Hill-Sachs lesions, and HAGL lesions are contraindicated for arthroscopic repair. They state that while arthroscopy has better cosmesis, decreased perioperative morbidity, decrease loss of external rotation, and is valuable in the confirmation of the extent and severity of shoulder instability, for these lesions open techniques are the gold standard. More recent studies support that arthroscopic treatment of HAGL lesions can still be effective in skilled hands. The Neviaser article discusses good results for arthroscopic debridement of GLAD lesions for pain relief.
2.5
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