Labral Repair Surgery

Labral Repair Surgery is a surgical procedure used to reverse damage to the labrum, or cartilage in the shoulder. The head of the upper arm bone (humeral head) rests in a shallow socket in the shoulder blade called the glenoid. A soft fibrocartilaginous  tissue (cartilage) rim called the labrum surrounds the socket like a form of “weatherstripping” and deepens it by up to 50% so that the head of the upper arm bone fits more securely and moves easily within the socket. If the labrum is torn, it can greatly hinder movement in the shoulder while causing a tremendous amount of pain.

The labrum can be torn due to a sports injury to the shoulder and often occurs in people who participate in football, baseball, golf, weightlifting and tennis or traumatic injuries such as falls or motor vehicle accidents. A labral tear can also be caused by the aging process that makes the labrum brittle and more susceptible to tears. When you have a labral tear, your shoulder becomes stiff and painful and tends to catch during movement. Activity will be limited and painful to accomplish. Labral repair surgery can regain motion in the shoulder and ease the painful symptoms.

Types of Labral Repair Surgery
The type of labral repair depends on the type of tear that has occurred in the shoulder. Most labral tears can be treated with nonsurgical treatment methods, but when painful symptoms persist despite treatment, labral repair surgery could be necessary. The different types of labral repair include:

• SLAP repair – SLAP stands for Superior Labrum from Anterior to Posterior which means that the tear runs from front to back in the socket of the shoulder. The SLAP tear occurs at the point where the bicep muscle tendon connects to the labrum in the shoulder socket.

SLAP repair is performed using Shoulder Arthroscopy Surgery, a minimally invasive surgical procedure used by orthopaedic surgeons to repair various painful diseases and disorders of the shoulder such as rotator cuff tendon tears, torn ligaments and bone spurs. An arthroscope is a small fiberoptic tube, about the diameter of a pencil, with a system of lenses, a light and a small video camera. The camera sends real-time images to a video monitor next to the operating table, thus allowing the surgeon to see more detail than is seen with a larger incision (open surgery) and the naked eye.

The arthroscope is inserted into the shoulder joint to inspect for a labral tear. Once the tear is found, the surgeon removes any excess tissue and drills a small hole in the bone where the labrum has torn away. An anchor attached to a strong suture is placed in the hole. One or more anchors may be used, depending on the extent of the injury. The sutures are then tied around the torn labrum to reattach it to the bone.

• Bankart repair – A Bankart lesion occurs when the patient sustains a shoulder dislocation injury and the labrum is disrupted and injured near the front or anterior aspect of the joint. When the shoulder pops out of the shoulder, this motion can tear the labrum in the shoulder socket. The particular section of the labrum that is usually anteriorly and inferiorly and is also attached to the inferior glenohumeral ligament which is usually injured as well. During this type of labral repair surgery, the torn labrum of the Bankart lesion is reattached to the socket of the shoulder.
• Internal impingement repair – Internal impingement occurs when the underside of the rotator cuff is pinched against the socket of the shoulder particularly in overhead athletes. This pinching is caused when the arm is moved all the way back in throwing position. Over time, this pinching can lead to the tearing of the tendon in the backside of the shoulder. Shoulder arthroscopy surgery is usually combined with a surgical procedure known as debridement or stabilization in order to correct the internal impingement. Debridement consists of removing loose tendon fragments, thickened bursa (fluid filled sacs that cushion the shoulder joint) and other debris around the shoulder joint.

The multidisciplinary team of orthopaedic experts at North Shore-LIJ Orthopaedic Institute's Shoulder & Elbow Services in New York performs Labral Repair Surgery as well as a broad range of nonsurgical and surgical treatments for conditions that affect the shoulder and elbow.

Rehabilitation Services
The Rehabilitation Network of the North Shore-LIJ Health System is dedicated to providing you and your family with result-oriented, comprehensive rehabilitation services. Our goal is to help you and your loved ones find relief from pain and get moving again after an accident, illness, injury or surgery. We’re your partner in a safe, healthy, more rapid recovery.