Labral Tear Surgery
What is a labral tear?
The labrum is a ring-shaped piece of cartilage that cushions the ball-and-socket joint of the shoulder. The labrum not only supports the ball-and-socket joint, but also the rotator cuff tendons and ligaments. Two different types of labral tears exist: SLAP tears (Superior Labrum from Anterior to Posterior) and Bankart tears.SLAP tears occur near where the biceps tendon attaches to the shoulder. SLAP tears are most commonly seen in athletes, such as baseball players. Bankart tears are seen when shoulder dislocation occurs. In the event that the humerus shifts out of position it may cause the shoulder to become unstable and result in a tear to the ligament attached to the bone. This type of tear occurs most often in young children.
What are the symptoms of a labral tear?
Symptoms of a labral tear include the following:
- Pain in shoulder joint
- Loss of strength or stability in the joint
- Reduced range of motion and flexibility
- Popping, grinding or locking of the joint
- Pain experienced when carrying out normal daily activities
- Pain when lifting the arms overhead
You may have an increased chance of having a labral tear if you have recently fallen on your shoulder or experienced a sudden pull or direct blow to the joint.
What are the risks accompanied with labral tear surgery?
Labral tear surgery is a highly successful procedure with minimal risk involved. There are, however, always some risks inherent in any surgical procedure, including:
- Adverse reaction to anesthesia
- Excessive bleeding
- Stiffness of the shoulder joint
It is important to discuss these risks with your surgeon prior to the procedure and determine if labral tear surgery is right for you.
How is labral tear surgery performed?
Labral tear surgery is performed arthroscopically. Anesthesia will be administered to keep you from experiencing pain. Regional nerve blocks are the most common form of anesthesia used for this procedure. A light general anesthetic may also be administered to make you feel more comfortable and relaxed.
A small incision is made with the use of the arthroscope and the images created with the device are viewed on a video screen. Using separate incisions, small surgical instruments are inserted to remove the torn tissue. If the shoulder is stable, the tendon or ligament does not need to be touched.
In the case of a SLAP tear, however, where the biceps tendon may also be affected, your surgeon may use removable sutures or wires to reattach the tendon. If the shoulder has become unstable as a result of a Bankart tear, the ligament will have to be reattached and tightened to the socket.
What can be expected after labral tear surgery?
Since anesthesia is administered for this procedure and drowsiness is likely to occur, you must have someone accompany you to your surgery. Pain and discomfort are to be expected after the procedure and can be controlled with either prescribed pain medication or over-the counter medication such as Tylenol. Swelling in the area is also expected and can be controlled with ice packs.
After surgery, you will be instructed to wear a sling for 3 to 4 weeks while your joint heals. Your surgeon will discuss the types of gentle rehabilitation exercises you can perform to help regain strength and mobility in your shoulder while it is still in the sling. It is important to begin gentle, passive exercises directly after surgery to prevent stiffness of your joint. Restrictions of certain daily activities, such as driving and lifting, are typical during the first 6 weeks after surgery
Once the sling is removed, physical therapy is recommended to improve your flexibility and strength. The plan put in place to help exercise your shoulder will depend on the extent of your injury and your overall health. Most shoulders are successfully healed within 3 and 4 months. Athletes who are in good health may be able to resume activity sooner if healing is successful.