Shoulder Labral Repair and Stabilization
The shoulder labrum is a fibrous cartilage which lines the ball-and-socket shoulder joint to provide stability and cushioning. It is a triangular, rigid, tissue that surrounds the shoulder blade. An injury to the labrum can cause dislocation or subluxation along with shoulder pain.
A labral tear is the most common injury to the labrum; it can be caused by traumatic accidents, congenital laxity, or arthritis. The two most common types of tears of the Labrum are SLAP tears and Bankart tears. A SLAP injury tears the biceps tendon from the glenoid, whereas a Bankart injury dislocates the arm by displacing the Humerus.
Depending on the severity of the tear, a torn Labrum can be reattached through minimally invasive or open labral repair shoulder surgery.
Who Needs the Surgery?
Labral Repair and Stabilization Surgery is recommended for patients who are:
- Suffering from a Labral tear because of congenital laxity or glenohumeral joint arthritis due to old age.
- Suffering a Labral tear from a traumatic accident.
- Not responding to conservative treatment options like pain medication, steroid injections, and physical therapy.
How is it Performed?
- Arthroscopic Transglenoid Suture Capsulorrhaphy is a minimally invasive shoulder labral repair procedure that begins by prepping the patient and administering local anesthesia.
- The surgeon makes a small incision in the joint to insert an arthroscope which transmits images from inside the joint.
- Afterward, the surgeon inserts anchors into the joint through separate incisions.
- The torn labrum is reattached to the rim of the bone with anchor sutures. In arthroscopic surgery, the patient is discharged 2-3 hours after the procedure.
- An open procedure is preferable for a type 2 or type 3 Labral tear.
- After administering general anesthesia or a brachial plexus nerve block, a cosmetic incision is made, which gives visibility and access to the shoulder joint.
- The labrum is reattached by roughening the edges of the shoulder socket and drilling small holes in it, through which sutures are passed.
- After the labrum has been securely reattached to the glenoid socket, the incision is stitched closed, dressing is applied, and the arm is placed in a sling. Patients are discharged two days after the surgery.
- A complete shoulder replacement is recommended instead of a repair if the joint is beyond salvaging.
- The surgeon recommends a rehabilitation program after arthroscopic or open surgery to recover optimal shoulder function. The program includes physical therapy and pain management.
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What Is Shoulder Stabilization Surgery?
- Arthroscopic shoulder stabilization is a surgical procedure used to treat chronic shoulder joint instability.
- This is a minimally invasive procedure and only requires two tiny incisions around a half-an-inch in length.
Can a Torn Labrum in the Shoulder Heal Itself?
- The labrum is not capable of complete self-healing and repair. If you decide to let it heal on its own, it probably won’t heal evenly.
- The surgeon can just clean up the torn area by removing any damaged cartilage if the labrum is slightly torn.
How Do You Treat Chronic Shoulder Instability?
- If all non-surgical procedures fail to relieve pain and instability in the shoulder, a surgical repair may be necessary to repair the torn or stretched ligaments.
- For some patients, a minimally-invasive arthroscopic surgery would suffice, while others require open surgery.