Navigating the Diagnosis and Treatment

The shoulder joint's stability is affected by a layer of cartilage known as the labrum that cushions and deepens the socket, or glenoid. However, certain physical activities or traumatic injuries can lead to a tear in the labrum. This results in a myriad of symptoms, including pain, limited motion, instability, and weakness in the joint.

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Causes of labral injury

Labral injuries typically occur due to one of two reasons: traumatic incidents or repetitive strain on the joint.

  • Traumatic incidents: Sudden, forceful movements or impacts such as those experienced in car accidents or during contact sports can lead to labral tears. These high-impact events can dislocate the joint, causing damage to the labrum.
  • Repetitive motions: Certain physical activities or occupations require repetitive overhead arm movements or hip rotations. Over time, these repeated motions can lead to gradual wear and tear of the labrum, eventually resulting in a tear.

Certain anatomical abnormalities or joint conditions can also contribute to labral injuries. These abnormalities include femoroacetabular impingement (FAI), a condition where an abnormal shape or damage to the joint surfaces causes them to rub against each other. This friction can damage the labrum, leading to a tear.

Do all labral tears require treatment?

It's important to note that not all labral tears cause symptoms or require treatment. Minor fraying of the labrum often does not produce symptoms and may not require treatment. However, larger tears can cause significant discomfort and instability in the joint, often requiring surgical intervention.

Over time, untreated labral tears can lead to further complications, such as damage to other tissues and cartilage within the joint, and potentially the development of osteoarthritis.

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Symptoms of labral injury

Labral injury symptoms may vary but often include:

  • Shoulder pain 
  • A popping or clicking sensation when moving the shoulder

Some individuals may experience weakness and a restricted range of motion. These symptoms are typically indicators of a labral tear and should prompt medical consultation.

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How can labral injury be treated?

Labral tears are diagnosed through a comprehensive medical history review and a physical examination. Patients may need to move their affected arm in various ways during the exam to assess the nature of the problem. Imaging tests such as X-rays or an MRI or CT scan may also be necessary to determine the extent of the damage and rule out other possible causes of shoulder pain. While many labral tears can be managed with pain management techniques and physical therapy, some cases may require surgical intervention.

Arthroscopy for labral tears

This procedure is typically carried out as an outpatient service and is often performed arthroscopically. Arthroscopy involves using a small camera to visualize the tear, while specialized tools are inserted through minimal incisions. This technique offers several advantages, including reduced tissue damage, quicker recovery periods, and minimal scarring. Nevertheless, more extensive tears may necessitate an open procedure.

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What is the procedure for labral repair?

After administering anesthesia, the surgeon makes the necessary incisions in the shoulder region. With a clear view of the labrum, the surgeon can assess the extent of the injury more accurately. The damaged section is then removed, and all required repairs are done. If there is a detachment from the tendon, it might require the use of sutures and anchors to ensure proper fixation. This is achieved by drilling tiny holes into the glenoid bone, where the anchors are then placed. Sutures are used to link the labrum to the anchors, which helps maintain the labrum's correct position and prevents future detachment.

What is the recovery for labral repair?

Following the procedure, patients typically wear a sling for three to four weeks to support and protect the arm. Physical therapy is initiated as soon as possible to restore flexibility, strength, and full range of motion to the shoulder.

The complete recovery time depends on several factors, including whether the procedure was performed using an arthroscopic or open approach, but it usually takes several months.

Who is a candidate for labral repair?

Candidates for labral repair surgery typically have persistent shoulder pain, limited motion, or instability that has not improved with conservative treatments like physical therapy or pain management techniques. They should be in good overall health and have realistic expectations about the outcomes of the procedure.

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Why choose New York Sports & Joints Orthopaedic Specialists for your labral repair?

At NY Sports & Joints Orthopaedic Specialists, we understand that you want the best when it comes to your health. That's why we're committed to providing top-tier medical care delivered by some of the most highly trained surgeons in the field.

Our team of surgeons are not only board-certified specialists, but they have also honed their skills and knowledge at some of the world's most prestigious institutions, including Princeton, Stanford, Harvard, Cornell, and Columbia. Their credentials are a testament to our dedication to excellence.

Innovative and pioneering, our team stays abreast of the latest advances and employs the most precise techniques available. Our surgeons have obtained fellowship and subspecialty training, with expertise spanning sports medicine, trauma, hand and wrist, foot and ankle, and joint replacements.

We are proud of our multidisciplinary approach to healthcare. Our team works with a single goal in mind: Restoring  optimal shoulder health and mobility with the least invasive approach.

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