Aim: Development of criteria for the medical-legal interpretation of differ
ent patterns of labral lesions according to the labrum pathology and mechan
ism of injury. Methods: A metaanalysis of the literature concerning injurie
s and diseases of the shoulder involving the glenoid labrum was performed.
Results: Lesions of the superior, anterior and posterior labrum are rare an
d of different severity. Arthroscopically they are divided into distinct ty
pes. They develop either spontaneously together with intraarticular disease
s, due to chronic fatigue or by injury. In this field the stability of the
shoulder joint and the tension of the long head of the biceps tendon play a
n important role. There is no correlation between the type of lesion and me
chanism of injury. With respect to medical-legal interpretation, the curren
tly used classification of labral lesions is not very helpful or is even co
nfusing. We therefore propose a new classification according to the meniscu
s pathology which shows a striking similarity to labral pathology. There ar
e two types of labral lesions: Type one shows degenerative defects, which m
ay be influenced by mechanical loading; type two follows from shoulder inst
ability. Conclusions: Medical-legal interpretation of labral lesions should
follow the same principles that were shown to be useful in knee joint inst
ability and meniscal tears. Only traumatic luxations of the shoulder joint
may lead to labral tears without any other alterations.