Labral Tear Shoulder Injuries: Surgical Treatment Options

If you have a symptomatic labral tear shoulder injury—meaning you have pain, weakness, reduced range of motion, and stiffness—shoulder surgery can be a successful treatment option. Labral tears not causing symptoms do not require surgery. As a shoulder specialist, my primary job is to determine whether you have a labral tear and if it is symptomatic.

As you may recall from an earlier post, there are several types of labral tears:

  • Those that occur from significant trauma, such as a dislocation;
  • Those caused by repetitive microtrauma, as seen in throwing athletes; and
  • Those that are due to labral degeneration that occur with age.

Degenerative labral tears may often be treated without surgery since they are frequently not symptomatic. However, labral tear shoulder injuries caused by trauma, whether a single violent event or multiple smaller (micro-trauma) events, often do require surgical treatment.

Depending on the location and extent of the injury, torn labrum surgery may be a debridement or a repair. Both options are minimally invasive outpatient procedures with high success rates. Keep reading to learn more about both options and how they can reduce pain and other symptoms of a shoulder labrum tear.

Labral Tear Shoulder Surgery: Debridement

Arthroscopic image of a posterior labral tear shoulder injury.

Some labral tears cause symptoms because the torn labral tissue irritates the capsule or adjacent lining of the joint. In other cases, the torn tissue catches in the joint when the shoulder moves.

When the shoulder tissue is significantly damaged, or the bulk of the labrum is attached to the glenoid (socket), leaving just a flap or small free piece of the labrum intact, “debridement” is typically the most effective shoulder surgery option.

During debridement, the torn labral tissue is removed arthroscopically using a motorized shaver or scissor-like instruments. Although this reduces remaining labral tissue, the torn tissue was incapable of doing its job, so removing it eliminates the symptoms without adversely affecting shoulder function. One way to think of debridement is that it’s similar to clipping a hangnail. In many cases, the bulk of the labrum remains attached to the glenoid, as do the shoulder ligaments. Consequently, the shoulder maintains stability and has full function.

Furthermore, since the tissue is not repaired or reattached to the glenoid, there is no need to protect it after surgery. Most patients use an arm sling for comfort for a few days. Physical therapy can start immediately, and there are no restrictions on activity other than those due to your pain.

The recovery period for a shoulder debridement is generally much shorter than for other labral tear shoulder surgeries. Most of my patients see improvement of preoperative symptoms within one to two months and fully recover within three to six months.

Torn Labrum Shoulder Surgery: Repair

Arthroscopic image of a superior labral (SLAP) tear shoulder injury.

Superior Labral (SLAP) Tear

When strong labral tissue separates from the glenoid, the preferred surgical solution is usually a labral repair.

This is almost always the case in those who have sustained traumatic instability events (dislocations or subluxations). Athletes who perform overhead motions (like swimmers, throwers, volleyball players) and sustain labral tear shoulder injuries also typically require surgical repair.

Labral repair surgery can be performed through larger incisions in an “open” manner or arthroscopically. I almost always perform labral repair procedures arthroscopically. Only in unique cases, with a significant injury to the humerus (upper arm bone) and/or glenoid, will I perform an “open” labral repair surgery.

Repairing a torn labrum arthroscopically includes several components:

  • The outpatient procedure allows patients to go home the same day.
  • The arthroscopic surgery is minimally invasive.
  • The procedure allows me to address associated issues like Biceps tendinitis, subacromial bursitis, or loose bodies at the same time without a second procedure.
  • The ability to remove any torn flaps of the labrum.
  • The option to mobilize the labrum if needed.
  • The procedure promotes blood flow at the glenoid attachment site to support healing.
  • The torn labrum can be reattached securely to the glenoid using suture anchors.
  • The post-operative treatment requires only a sling for support, with or without an ice sleeve.

To help you better visualize these procedures, watch the following videos to see arthroscopic labral repairs of tears at various locations on the glenoid.

If you have further questions or want to schedule an appointment, please reach out to Town Center Orthopaedics’ Reston office at (703) 435-6604 or the Centreville office at (703) 378-4860.

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