Kim lesions are superficial tears between the posterior glenoid labrum and glenoid articular cartilage without labral detachment. Failure to identify and treat this lesion may lead to permanent posterior instability.
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Pathology
It typically results from a posteroinferiorly directed force on the labrum with a deep and/or intrasubstance incomplete detachment of the posteroinferior labrum from the glenoid accompanied by a separate superficial tear between the posteroinferior labrum and articular cartilage. This tear, which is not a complete labral avulsion, is called a “marginal crack”
Radiographic features
It is important to recognize Kim's lesion, because it can lead to chronic glenohumeral instability.
MRI
flattening or incomplete avulsion of the posterior labrum
normal relation of glenoid cartilage and posterior labrum
MR arthrography
May shows a thin collection of contrast material entering a cleft between the posteroinferior glenoid and the glenoid labrum. There is no displacement of the labrum.
Treatment and prognosis
Labroplasty is performed to restore the labral height and includes converting incomplete lesion to a complete tear and repairing it with a suture anchor, sometimes accompanied by shifting of the posterior capsule or of both the posterior and inferior capsule.
History and etymology
It is named after South Korean orthopedic surgeon Seung-Ho Kim who first described the condition in the literature in 2004 2.
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