The socket of the shoulder, or glenoid, is covered with a layer of cartilage called the labrum that cushions and deepens the socket to help stabilize the joint. Traumatic injuries and repetitive overhead shoulder movements may cause a tear in the labrum, leading to pain, limited motion, instability and weakness in the joint.
SYMPTOMS OF A LABRAL INJURY
Symptoms of a labral injury may include shoulder pain and a popping or clicking sensation when the shoulder is moved. Some people experience weakness and a restricted range of motion as well.
DIAGNOSING A LABRAL INJURY
A labral tear is typically diagnosed through imaging tests, a physical examination and a review of symptoms. While many labral tears can be treated by managing pain symptoms through medication and undergoing physical therapy, some cases require surgical treatment.
THE SHOULDER LABRAL REPAIR PROCEDURE
Labral repair surgery trims the damaged portion of the labrum in the shoulder and if necessary, secures it with staples, anchors or sutures. This outpatient procedure is usually performed through arthroscopy, which allows the doctor to view the tear through a small camera and insert the specialized tools through tiny incisions. Patients can benefit from less tissue damage, shorter recovery times and less scarring with arthroscopic techniques. However, larger tears may require an open procedure.
Once anesthesia has been administered, the surgeon will make the incisions in the shoulder area. Upon obtaining a visualization of the labrum, the injury can be better evaluated. The torn area will be removed and all necessary repairs are made. If a separation from the tendon has occurred as well, it may require the use of sutures and anchors to achieve fixation by drilling tiny holes in the glenoid bone in which the anchors are then embedded. Sutures are used to connect the labrum to the anchors, maintaining the correct positioning of the labrum and preventing the labrum from detaching again.
RISKS OF A LABRAL REPAIR PROCEDURE
Labral repair procedures are considered safe, but all forms of surgery carry some risk. The risks generally associated with a labral repair may include infection, bleeding, formation of a blood clot, shoulder stiffness, shoulder weakness and nerve damage.
RECOVERY FROM A LABRAL REPAIR PROCEDURE
It is important to properly support and protect the arm immediately following a labral repair surgery, so most patients typically wear a sling for three to four weeks after the procedure. Physical therapy begins soon after the surgery and can be very helpful in restoring the flexibility, strength, and full range of motion to the shoulder. Most patients can typically return to jobs and other activities that are mainly sedentary after a few weeks. As healing progresses, athletes will be able to gradually participate in sports again. Complete recovery time may vary and depends on a number of factors, including whether the procedure was performed using an arthroscopic or open approach, but usually takes several months.
Labral repair surgery is usually effective in treating labral tears, eradicating pain and regaining complete mobility in the arm.