Labral Tear (SLAP) Tear
The labrum is a rim of cartilage attached circumferentially around the shoulder socket or glenoid. These injuries often occur in overhead athletes such as baseball players, but can occur in many sports. Physical examination in conjunction with an MRI is used to diagnose the injury. Symptoms often include pain, loss of strength, perceived instability, and catching or locking of the shoulder. A SLAP tear can occur acutely with a specific identifiable injury, with repetitive use, or chronically secondary to degeneration of the tissue. Recommended initial treatment is most often rehabilitation and rest from activity. Arthroscopic surgery is commonly performed for failure of non-operative treatment and sometimes as initial treatment for acute injuries.
Surgical treatment involves either debridement with removal of torn tissue or repair of the labral tear. Repair is performed by placing anchors or screws into the shoulder socket with attached sutures placed through the adjacent labrum. Results after surgical repair of a torn labrum have been excellent. Return to athletic activities after repair is typically 3-4 months, but highly dependent on the sport played. Recovery for a throwing athlete will typically be longer with a graduated throwing program.
Shoulder Instability and Bankart TearShoulder dislocations most often result in a torn anterior labrum or Bankart lesion. This can result in recurrent instability or repeat shoulder dislocations particularly in young athletes. Non-operative treatment plays a significant role in treatment of this injury. However, surgical repair has more recently been utilized acutely for young patients who are at much higher risk for repeat dislocation episodes with excellent results.
Arthroscopic shoulder surgery is commonly used to treat recurrent instability and Bankart tears. This procedure typically involves repairing the torn labrum and/or tightening a loose joint capsule to the socket of the shoulder joint. The procedure is often referred to as a Bankart repair or capsulorraphy. The repair is performed by placing anchors or screws into the shoulder socket with attached sutures placed through the adjacent labrum and capsule. Return to athletics is typically 4 months following surgery.