Bone and Joint Specialists of Winchester provides advanced shoulder labrum repair options.
All of our surgeons perform arthroscopic repair shoulder labrum tears. Dr. Larson’s primary focus is on shoulder care and he is happy to see patients for second opinions on shoulder labrum injuries. Many other surgeons in our area refer patients to Dr. Larson for treatment of shoulder labrum tears that require advanced management.
What is the shoulder labrum?
The shoulder labrum is ring of cartilage that circles the socket of the shoulder joint. It helps to keep the shoulder from dislocating and provides and anchor for many ligaments and some tendons of the shoulder.
Do I have a shoulder labrum tear?
You might have a shoulder labrum tear if you have the following signs or symptoms:
- Pain in the shoulder when throwing or lifting weights
- Pain when reaching behind you
- Weakness in the shoulder
- Pain at night when sleeping on the shoulder
Although it is possible to tear the shoulder labrum through an injury such as a fall, many people tear their shoulder labrum slowly through repetitive use also. Labrum tears are common in shoulder-focused athletics such as pitching, baseball or softball, volleyball, swimming, and weight lifting.
What shoulder labrum surgery do you need?
Most shoulder labrum tears can be repaired, but not all of them need to be. Sometimes a simple arthroscopic shaving of the damaged area is all that’s needed to get you back to normal function. What surgery is best for you depends on your age, activity level, symptoms and goals, as well as characteristics of the labrum tear.
What is a shoulder labrum repair?
Most of the time we can repair labrum tears of the shoulder tears via arthroscopic techniques, using small instruments through “poke hole” incisions. Arthroscopy allows for better visualization, more precise surgery, less shoulder trauma, less postoperative pain and a better cosmetic appearance, all while having the same healing, function, and pain relief.
First the tear is identified. Then any scar tissue is removed from the site of damage and the surface of the bone is roughened to allow better healing. Then small anchors are placed in the bone where the labrum should be attached. Stitches attached to these anchors are then around the labrum. As these stitches are tied down, it brings the labrum back to the bone and locks it into place until it can heal.
What are the restrictions after shoulder labrum repair?
After a simple cleanup of the labrum, you can usually be out of the sling within a couple days. But after a repair, the arm and shoulder must be immobilized in a sling for about four to six weeks after surgery. This depends on the size of tear and how it could be repaired. We usually start an accelerated therapy protocol within a couple weeks of surgery. But if you do too much, it’s possible to damage the repair.
What happens on the day of shoulder labrum surgery?
Shoulder labrum repairs are performed as an outpatient. The anesthesiologist will put you to sleep for the surgery. But before that they will administer a nerve block by doing an injection near the collarbone. This will numb your arm and shoulder so that you feel less pain. This also allows them to give you less anesthetic and narcotic medication while you are asleep. That means less nausea, vomiting, or grogginess after surgery.
Once asleep, you will be properly positioned and prepared for surgery. The surgery usually takes an hour or less, but bigger tears may take longer. Once the surgery is completed, a dressing and sling are applied. You are awakened from anesthesia and taken to the recovery area. Once you are awake, drinking, and recovered, the nurses will help you dress and then you are able to go home.
What if my shoulder labrum tear is not repairable?
If your tear is not repairable but non-operative treatments are unsuccessful, there are other options:
- Arthroscopic Debridement
- Partial Shoulder labrum Repair
- Copeland hemiarthroplasty
- Superior Capsular Reconstruction
- Reverse Total Shoulder Replacement
Arthroscopic Debridement
Even though your torn shoulder labrum may not be repairable, sometimes cleaning out the shoulder joint and removing other causes of pain may help you feel better. This won’t prevent you from having any other treatments for the shoulder down the line. And it can give you some improvement in pain and function.
Partial Shoulder labrum Repair
Sometimes we can repair only a portion of the shoulder labrum. But that can provide significant pain relief and improved function. This is because some parts of your shoulder labrum are more important that others. By repairing those we can get you closer to normal even though the shoulder isn’t perfect.
Copeland Hemiarthroplasty
A partial replacement of the joint can provide some relief of pain and improved function of the shoulder. The Copeland is a steel cap that fits over the ball of the shoulder joint. It allows the shoulder to move while preventing pain from the lack of shoulder labrum.
