The GLAD lesion: another cause of anterior shoulder pain.

A GLAD (glenolabral articular disruption) lesion is caused by a forced adduction injury to the shoulder from an abducted and external rotated position; patients with GLAD lesions present with anterior shoulder pain as their chief complaint. No signs of anterior instability are found on physical examination or at surgery. All cases are relieved of anterior shoulder pain by lidocaine injection intraarticularly during the arthrographic examination, but arthrographic examinations are normal. At surgery, a superficial anterior inferior labral tear has been identified in all cases associated with an anterior inferior glenoid articular cartilage injury. Arthroscopic debridement of the labral tear with glenoid articular chondroplasty or abrasion arthroplasty is the treatment of choice. All symptoms were eliminated within 3 months after the surgical debridement in all cases.