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 can cause a tear in the labrum, leading to pain, limited motion, instability and weakness in the joint.
Symptoms of a labral injury can 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. A labral tear is typically diagnosed after a medical history has been taken and a physical examination performed. During the exam, patients may need to move the affected arm in various ways in order for the doctor to assess the nature of the problem. In addition, imaging tests such as X-rays or an MRI or CT scan may be necessary to determine the extent of the damage and rule out other possible causes for shoulder pain.
While many labral tears can be treated by managing pain symptoms and undergoing physical therapy, some cases require surgical treatment. Labral repair surgery aims to trim the damaged portion of the labrum in the shoulder and if necessary, secure 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.
It is important to properly support and protect the arm immediately following a labral repair surgery. In order to achieve this, patients typically wear a sling for three to four weeks after the procedure. Physical therapy is begun as soon as possible since it can be very helpful in restoring the flexibility, strength and full range of motion to the shoulder.
Labral repair surgery is usually effective in treating labral tears, eradicating pain and regaining complete mobility in the arm. 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 begin practicing their sport once again. Complete recovery time 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 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.
