Labral Repair of the Shoulder
What is labral repair of the shoulder?
Labral repair of the shoulder is surgery to repair an injury to the labrum, the cuff of cartilage that surrounds the shoulder joint and helps provide stability to the shoulder.
The vast majority of shoulder labral repairs are performed arthroscopically. In this minimally invasive approach, the surgeon makes several small incisions around the shoulder joint and inserts a narrow fiber optic scope (called an arthroscope) to examine the condition of the labrum. Tiny instruments are used to remove the frayed edges, if the tear is small, or repair and reattach the tendon, if the tear is more severe. Repair is usually done with small anchors attached to the bone and sutures to secure the torn labrum.
Arthroscopic repair of labral injuries allows surgeons a full view of the shoulder without having to cut through muscles or open the shoulder joint. Patients therefore experience less pain, minimal blood loss, fewer complications and a faster recovery. The result is a more balanced anatomic repair that helps restore full function and anatomy.
The labrum is a ring of firm tissue that circles and cushions the shoulder. It makes the shoulder joint more stable, helps keep your humerus (upper arm bone) in the shoulder socket and allows for a wide range of arm movements. The labrum is susceptible to injury with trauma to the shoulder joint. It also becomes more brittle with age, and can fray and tear as part of the aging process.
There are several different types of labral tears:
- SLAP (superior labrum anterior and posterior) tears are injuries to the uppermost part of the labrum, where the biceps tendon attaches to the shoulder.
- Bankart tears are injuries to the lower part of the labrum and occur when the shoulder dislocates.
- Posterior labral tears are less common and occur when the rotator cuff and labrum are pinched together in the back of the shoulder, a condition called internal impingement.
These photos taken through an arthroscope show a normal shoulder joint lining (left) and an inflamed joint lining damaged by frozen shoulder.
When is surgery recommended?
Treatment of a torn labrum depends on the type and severity of the injury. Most labral tears do not require surgery. Your doctor may prescribe non-operative treatment such as rest, anti-inflammatory medication and exercises to strengthen the rotator cuff muscles. If these conservative measures are insufficient, there is persistent instability, or the patient places high demands and his or her shoulder, arthroscopic surgery may be recommended.
What is the recovery time?
Total rehabilitation time depends on the extent and severity of your injury and the strength of the repair. It usually begins with four to six weeks of shoulder immobilization in a sling, followed by six to 12 weeks of physical therapy to restore range of motion, flexibility and strength. Athletes can usually begin doing sport-specific exercises and training 12 weeks post surgery. Unrestricted return to contact sports usually requires five to six months of rehabilitation.