Understanding Shoulder Labral Repair 

🔳Overview

Labrum anatomy

The shoulder socket's rim is lined with a fibrocartilage ring known as the labrum. It is an essential part of the shoulder joint because it widens the socket and aids in shoulder stabilization. Numerous tendons and ligaments that assist stabilize the shoulder joint adhere to the labrum as their point of attachment. It serves as a joint cushion as well, absorbing shock and lowering friction when moving. 

The superior labrum is where the biceps tendon attaches to the labrum. This is the 'top' of the labrum. Additionally, it helps to stabilize the shoulder joint when performing overhead motions like throwing a ball.

The anterior labrum aids in preventing the humeral head from dislocating anteriorly.

The posterior labrum aids in preventing the humeral head from dislocating posteriorly.

Types of Labral Tears

Labral tears can take many different forms, such as SLAP tears, Bankart tears, and posterior labral tears.

SLAP Tear

A tear in the labrum at the top of the shoulder socket is referred to as a SLAP tear. Repetitive overhead activities, such as tossing a ball or lifting weights, are a common cause of this kind of damage. The discomfort, vulnerability, and a seizing or closing feeling in the shoulder are all signs of a SLAP injury.

Bankart Tear

A labrum tear near the posterior (bottom) of the shoulder joint is known as a Bankart tear. Such a rupture is frequently brought on by a severe injury, like a dislocated shoulder. Pain, instability, and a sense that the shoulder is "slipping" out of position are all signs of a Bankart tear.

Posterior Labral Tear

A tear in the labrum at the back of the shoulder socket is referred to as a posterior labral tear. This kind of tear, which is less frequent than SLAP and Bankart tears, is frequently brought on by a violent injury, like a fall onto an extended hand. A posterior labral tear can cause shoulder pain, weakness, and a sense of instability.

Arthroscopic labral repairs start with your surgeon making a small incision to insert a camera into your shoulder. Once your surgeon gains access to your labral tear arthroscopically they will make a 2nd incision to insert their surgical instruments. These instruments are visualized by the camera that is already at the site of the labral tear.

       
This is your surgeon’s view of your shoulder during an arthroscopic labral repair: (see photo on the side)

Tear and Repair Diagnosis

You most likely had an MRI prior to this surgery. MRI imaging is effective at imaging soft tissue, such as the labrum, and telling your surgeon if you have a labrum tear. However, MRIs do not provide granular details of the nature and ‘shape’ of your labrum tear. This information can only be obtained by visualizing the tear with an arthroscopic camera.

Once your surgeon has visualized your tear arthroscopically, they will manipulate your shoulder and labrum to determine the severity, size, and shape of your tear. This manipulation is performed by both moving your arm and using grasping surgical tools to move your tear in different directions.

This manipulation provides your surgeon with the information they need to decide on the best labral repair technique for your tear:

• The pattern of your tear
• Your current and pre-tear anatomy
• The mobility of your shoulder

Labral Repair Techniques:

Labral repair of the shoulder can be performed using several different methods, the selection of which will depend on the severity and location of the tear, as well as the surgeon's choice of technique and level of expertise.

Good labral repair surgeons will attempt to repair your labrum in a way that mimics your pre-tear anatomy. The more repair techniques they have in their ‘tool belt’ the more likely they are to succeed.

Methods that are typically used include:

Arthroscopic Repair

In this minimally invasive procedure, a camera, and miniature surgical instruments are introduced into tiny incisions in the shoulder. The camera aids the surgeon in locating the rip, and the devices are used to stitch or secure the torn labrum back to the bone.

Open Repair

A wider incision in the shoulder is made to gain access to the torn labrum during an open surgery, which is sometimes essential. When surgical repair is not an option, or when the tear is particularly complex, this method may be utilized.

Non-operative Management

Physical therapy, lifestyle change, and pain management may be enough to treat a minor labral tear without the need for surgery.

Repair

Depending on the size and location of the tear, your surgeon may use one of two approaches: a labrum debridement or a labrum reattachment.

After the procedure

After the effects of the anesthesia fade off and your vital signs are stabilized, you will be observed in a recovery room.

For the repaired labrum to heal properly, the arm may need to be restrained in a sling or brace for a certain amount of time.

The physician may recommend physical therapy and rehabilitation activities to assist you to regain shoulder strength, range of motion, and flexibility.

Your surgeon will schedule follow-up appointments to check on your progress and modify your rehabilitation program as needed.

If you want the greatest potential results from a shoulder labral repair treatment, you should follow all pre-operative instructions and post-operative recommendations given to you.

🔳 Risks and Benefits

Benefits

• improved strength and flexibility of motion in the shoulder 
• decreased discomfort and pain in the shoulder.
• enhanced ability to do daily activities.
• decreased chance of further damage and injury to the shoulder

Risks

• anesthesia-related issues
• shoulder stiffness or weakness
• labrum healing improperly
• infection at the surgical site
• nerve damage; blood vessel damage
• need for additional surgery
• an infection at the surgical site

How to Reduce the Risks?

You can minimize potential complications from shoulder labral repair by taking the following measures:

• Pick an expert shoulder surgery with experience and credentials. Contact Surgeon Researcher so we can verify their history of accomplished labral repairs.
• Carefully adhere to the pre-op instructions provided by your surgeon. This may entail prepping yourself for surgery through physical activity, flexibility exercises, and a balanced diet.
• To help lower the chance of problems, stop smoking prior to and following surgery.
• Tell your surgeon the truth about all medicines you are consuming, including nutritional supplements and over-the-counter remedies. Some of these might make it more likely that there will be bleeding or other issues both during and after the operation.
• Carefully adhere to your surgeon's post-operative recommendations. This may entail adhering to drug regimens, going to physical therapy sessions, and refraining from activities until your shoulder is totally recovered.
• Any unexpected symptoms or problems, including fever, significant swelling, bleeding, or infection symptoms, should be reported to your surgeon right away.

What do we look for in a surgeon that performs shoulder labral repairs?

1. Our Surgical Sources must be comfortable sending their family members to the surgeon.
2. The surgeon must specialize in shoulder surgery and be a high-volume surgeon.
3. The surgeon must be board-certified and have a good track record of successful surgeries.
4. The surgeon must be performing shoulder labral repairs weekly.
5. The surgeon must use the latest technology and equipment to perform shoulder labral.
6. The surgeon must have good hand-eye coordination.

Surgeon Researcher - Final Words

The best predictor of successful surgery is the skill level of your surgeon. Surgeons are NOT created equal.

Studies, and our experience, show that patients who are operated on by the most skilled surgeons have lower rates of revision surgery, complications, infection, pain, opioid use, and death. The most skilled surgeons achieve the best surgical outcomes - providing you with the quickest recovery and best quality of life.

Finding the most skilled surgeon can be an impossible task if you do not work in the medical industry. Surgeon Researcher is here to change that.

The only sources that know how skilled a surgeon really is are in the operating room with surgeons on a consistent basis.

We talk to these sources.

We are the only service dedicated to finding patients like you the most qualified surgeons in the country by going straight to the source. Our goal is to equip you with all the information you need to make an informed choice about your health care.

Here at Surgeon Researcher, we prioritize the needs of our customers. We are advocates for the patients, not surgeons.

Don't risk your future quality of life. Get in touch with Surgeon Researcher so we can ensure a qualified surgeon is performing your surgery. You can rely on us to be your advocate in the fight for better surgical outcomes.