NYU Langone doctors may recommend surgery to repair a shoulder labral tear if nonsurgical treatments such as physical therapy have not helped the injury heal.
Surgery for a shoulder labral tear usually takes an hour and is an outpatient procedure. Our fellowship-trained, internationally known orthopedic surgeons typically use arthroscopic surgery, also called arthroscopy, which is performed through three or four small incisions, rather than one large open incision. Smaller incisions allow for more-rapid healing and recovery. A tiny camera, inserted through one of these incisions, enables doctors to view your shoulder joint, the damaged labrum, nearby ligaments, and the surgical repair.
After surgery, you may need to wear an arm sling, which helps rest the shoulder, for about four to six weeks. Physical therapy is also an important part of your recovery.
Our doctors carefully consider your age, overall health, and how physically active you are to determine whether you are a candidate for superior labrum anterior and posterior (SLAP) tear surgery. However, most SLAP tears can be successfully treated without surgery in older patients. Younger patients often require surgical intervention.
For debridement of a SLAP tear, doctors use small surgical tools to remove any frayed tissue or scar tissue from the labrum, helping to smooth the cartilage. This approach may be an option for tears that do not affect the biceps tendon. The biceps tendon attaches the biceps muscle, located in the front part of the upper arm, to the labrum. Surgeons typically only use debridement if the point at which the biceps tendon attaches to the labrum is secure.
If the labrum has fully detached from the shoulder socket, also known as the glenoid, your surgeon reattaches it by placing plastic anchors through the labrum and into the bone. If the biceps tendon is also torn, doctors reattach it to the labrum and glenoid. This procedure may be an option for people who have an otherwise healthy shoulder joint with no degeneration.
For a biceps tenodesis procedure, your surgeon cuts the long head of the biceps tendon, meaning where it connects to the labrum, and reattaches the tendon to the humerus, or upper arm bone, just below the shoulder. This helps to reduce the force placed on the superior labrum when you move your arm, helping to reduce pain. This procedure may be an option for older people who have inflammation or tearing in the biceps
During Bankart repair surgery for a tear with shoulder dislocation, your doctor sutures the torn labrum to the glenoid at the point where it detached. Your doctor also places plastic anchors through the labrum and into the bone. The aim of surgery is to improve shoulder stability and to prevent future dislocation of the upper arm bone from the socket.
A labral tear caused by the anterior dislocation of the shoulder may also be accompanied by torn ligaments that need to be sutured to the glenoid, further stabilizing the joint. The edge of the glenoid may also break with shoulder dislocation, requiring either repair or reconstruction with a bone graft. Your surgeon may be able to repair this arthroscopically. In some cases, where there is too much bone damaged on the socket, a Latarjet—bone grafting—procedure is required.
A tear caused by a posterior dislocation can also be repaired using sutures and several anchors. The glenoid bone may also be broken in the back—a reverse Bankart fracture—which requires repair.
Your doctor discusses whether you may benefit from surgery for multidirectional instability of the shoulder with labral tears. For this procedure, surgeons sew the torn labrum back to the glenoid and place anchors around the rim of the shoulder socket to tighten loose ligaments.
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