Articular shear of the anterior-inferior quadrant of the glenoid: a glenolabral articular disruption lesion variant

Traumatic cartilage lesions of the shoulder, such as glenolabral articular disruption (GLAD), have previously been recognized in patients with shoulder instability. We describe a new lesion in which the entire anteroinferior quadrant of the glenoid articular cartilage is sheared off in association with an adjacent labral tear. Both patients were teenage athletes who were being treated arthroscopically for shoulder instability. Preoperative imaging showed some evidence of an articular cartilage lesion. One patient was treated with removal of an irreparable fragment and microfracture, while in the other case the cartilage flap was reattached to the glenoid with a chondral fixation device. This GLAD lesion variant is a serious cartilage injury to the shoulder in young athletes that may be subtle, but needs to be recognized for proper arthroscopic treatment.