What Is It?

Arthroscopic Shoulder Labral Repair is a minimally invasive surgical procedure meant to repair damaged portions of labral cartilage in the shoulder.

The labrum, also described as labral cartilage, is a collection of thick, fibrous tissue found in the shoulder and hip joints. Specifically, the shoulder labrum forms a rim around the glenoid (socket) which helps deepen the shallow shoulder articulation with the humeral head. Much like a rotator cuff, the labrum provides the shoulder joint with stability and allows it to move freely in a variety of unique ways.

Why Is It Done?

Injuries to this rim of tissue most commonly stem from acute trauma or other types of strenuous, repetitive arm motion. Specific incidents like absorbing a blow to the shoulder, or attempting to break a fall with an extended arm can cause significant damage within the labrum. Participation in certain sports that call for aggressive arm activity can also harm shoulder tissue over time. The labrum tears in multiple ways, and treatment differs depending on whether the tear occurs above or below the equator of the shoulder socket. Tears above the socket’s center, known as SLAP (Superior Labrum, Anterior to Posterior) Lesions, can also include damage to the biceps tendon. A tear below the socket is generally referred to as a Bankart Lesion, and typically accompanies a dislocated shoulder.

Damage or tearing in the shoulder labrum often leads to intense pain and a sense of instability when attempting overhead activities. Tears limit arm strength and mobility, and can present themselves in the form of uncomfortable locking, popping, or grinding sensations in the shoulder. Patients have also reported disturbed sleep as a common symptom of shoulder tissue damage.

In the event of a torn labrum, many patients respond favorably to non-surgical treatment, such as physical therapy, anti-inflammatory medication, cortisone injections, and simple rest. If pain and irritation persists, however, arthroscopic surgery to repair or debride (clean-up) the labrum is the most common recommendation.

How Is It Done?

Arthroscopic surgery is a minimally invasive procedure in which a high-definition, fiber optic camera is inserted through small incisions to evaluate the glenohumeral joint (shoulder joint), and supporting soft tissues, including the four rotator cuff muscles, labrum, biceps tendon, articular surfaces, ligaments, and bone. Once able to visualize the joint from inside, arthroscopic surgery allows surgeons to diagnose specific joint injuries and diseases, and even provides a way to treat certain problems by utilizing surgical instruments through tubes called cannulas.

Arthroscopic surgery to repair a damaged shoulder labrum most commonly involves: shaving away the torn portion to create a high-functioning, smooth edge, or physically repairing and reattaching torn tissue with anchors and sutures.

Generally, as arthroscopic surgery is performed in the least invasive manner possible, recovery is quicker and less painful. Most patients return home on the same day in which they have the surgery, and will have their arm protected in a sling or an abduction pillow for a 3-4 week period. Once removed from protection, it’s important to gradually increase flexibility in the shoulder and strengthen the biceps through physical therapy and exercise. Complete recovery varies, but 3-4 months typically pass before the shoulder will near full functional capacity from labral repair surgery. Complete healing of the shoulder, including resolution of swelling and minor aches and pains, may take as long as a year.