If you’ve hurt your shoulder, there’s a good chance that you may have torn your labrum. The labrum is an area of cartilage that helps connect your arm to your shoulder, and a tear here can cause pain, weakness, reduced range of motion, and stiffness. If you have a torn labrum, shoulder surgery can be a successful treatment option. On the other hand, a labral tear shoulder injury that isn’t causing symptoms usually doesn’t require surgical intervention.
The primary job of our team of shoulder specialists is to determine whether you have a labral tear and if it is symptomatic, requiring labrum surgery.
There are several types of labral tears:
- Those caused by significant trauma, such as a dislocation
- Those caused by repetitive micro-trauma, like throwing a ball
- Those caused by normal labral degeneration that occurs with age
Since they usually are not symptomatic, degenerative labral tears are often treated without surgery. However, labral tears caused by trauma, whether a single violent event or multiple smaller (micro-trauma) events, often do require surgical treatment. Let’s take a closer look at your options in these cases.
Which Torn Labrum Shoulder Surgery Option Is Right for You?
Depending on the location and extent of the injury, your surgeon may perform either debridement or a repair. Both options are minimally invasive outpatient procedures with high success rates.
Labral Tear Shoulder Surgery: Debridement
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.
If the shoulder tissue is significantly damaged, or if 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 labrum surgery option.
What Is Debridement?
During debridement, the torn labral tissue is removed arthroscopically using a motorized shaver or scissor-like instruments. Although this reduces the total amount of remaining labral tissue, the torn tissue was incapable of doing its job, so removing it eliminates the symptoms without further decreasing 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.
What Is Recovery Like After Debridement?
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 torn labrum surgeries. Most patients see improvement in their preoperative symptoms within one to two months and fully recover within three to six months.
Labral Tear Shoulder Surgery: Repair
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 often require surgical repair, although on occasion, different types of surgery may be required.
How Is Labral Repair Surgery Performed?
Labral repair surgery can be performed either arthroscopically or as open surgery using larger incisions. Labral repair procedures are often performed arthroscopically; only in unique cases, with a significant injury to the humerus (upper arm bone) and/or glenoid, will we perform an open labral repair surgery.
Repairing a torn labrum arthroscopically is a minimally invasive outpatient procedure. We reattach the torn labrum securely to the glenoid using suture anchors. Patients can go home the same day.
The surgery allows us to:
- Address any associated issues like biceps tendonitis, subacromial bursitis, or loose bodies without a second procedure.
- Remove any torn flaps of the labrum.
- Mobilize the labrum if needed.
- Promote blood flow at the glenoid attachment site to support healing.
The post-operative treatment requires only a sling for support, with or without an ice sleeve.
If you have further questions or want to schedule an appointment to discuss your shoulder pain and difficulties, please reach out to Town Center Orthopaedics’ Reston office at (571) 346-2411 or the Centreville office at (703) 378-4860.