Shoulder Labrum Repair

Overview

Shoulder labrum repair is a surgical procedure to reattach and stabilize the torn labrum, the ring of cartilage that surrounds the shoulder socket (glenoid). The procedure is most commonly performed arthroscopically and addresses tears such as Bankart lesions (anterior-inferior labrum) or SLAP tears (superior labrum). Labral repair aims to restore shoulder stability and reduce pain.

Indications

This procedure may be considered when:

• •Recurrent shoulder instability or dislocations with Bankart lesion
• •SLAP tears causing pain, clicking, or functional limitation
• •Traumatic labral tears in active individuals
• •Posterior labral tears with instability
• •Failed conservative treatment with persistent symptoms
• •Athletes requiring return to throwing or overhead sports

How It Works

The procedure typically involves several coordinated steps:

• •The procedure is typically performed arthroscopically under general and/or regional anesthesia
• •Small portals are created around the shoulder for camera and instrument access
• •The labral tear is identified and the tissue quality is assessed
• •The glenoid rim is prepared by removing scar tissue and creating a bleeding bone surface
• •Suture anchors are placed into the glenoid bone at the tear site
• •Sutures from the anchors are passed through the labral tissue
• •The labrum is secured back to the glenoid rim in its anatomical position
• •Capsular plication (tightening) may be performed if the capsule is stretched
• •The repair is evaluated for stability and the portals are closed

Risks

As with any surgical procedure, potential risks include:

• •Recurrent instability or failure of the repair
• •Stiffness or loss of range of motion
• •Infection of the surgical site or joint
• •Nerve injury
• •Persistent pain despite technically successful repair
• •Anchor-related complications (migration, loosening)
• •Chondral injury during the procedure
• •Blood clots
• •Need for revision surgery

Recovery Expectations

Recovery follows a gradual progression:

• •Arm is typically immobilized in a sling for 4 to 6 weeks
• •Position of immobilization may vary based on type of repair (internal vs external rotation)
• •Passive range of motion begins early under supervised therapy
• •Active motion progresses after initial healing period
• •Strengthening exercises begin around 3 months postoperatively
• •Return to non-contact activities may occur around 3 to 4 months
• •Return to contact sports or throwing typically requires 6 months or longer
• •Complete rehabilitation may require 9 to 12 months for overhead athletes

Alternatives

Depending on individual circumstances, alternatives may include:

• •Physical therapy focusing on rotator cuff and scapular strengthening
• •Activity modification to avoid provocative positions
• •Bracing during sports activities
• •Open surgical repair (Latarjet procedure) for significant bone loss or failed arthroscopic repair
• •Watchful waiting for low-demand patients with minimal symptoms

Sources

• AAOS OrthoInfo – Shoulder Instability
• Mayo Clinic – SLAP Tear