I had never heard of a ‘Buford complex‘ until I read the surgery report that stated I have one in my left shoulder. Present in only 1.5% of the population, A Buford complex is a congenital labral variant where the superior labrum is absent and the middle glenohumeral ligament is thickened. A Buford complex can be mistaken for a superior labral tear.

The Buford complex has previously been thought to be a normal anatomic variant with minimal clinical significance. The purpose of this study was to determine a potential correlation of an arthroscopic finding of a Buford complex and superior labrum anterior-posterior (SLAP) lesions in patients. Two hundred fifty consecutive shoulder arthroscopies performed at one institution were reviewed retrospectively. Operative reports and arthroscopic pictures were carefully inspected, with particular attention paid to descriptions of labral variations and pathology. Two hundred thirty-five reports met criteria for study inclusion. Of the 235 cases, 6 had a Buford complex (2.5%), displaying a cordlike middle glenohumeral ligament and absent anterior-superior labral tissue. Of these 6 patients, 5 had a corresponding SLAP lesion (83.3%). Of the remaining 229 patients 40 had SLAP lesions (17.5%). The significant difference between these groups (P < .003) indicates that there is a correlation of patients with Buford complexes and SLAP lesions.