ARTHROSCOPIC LABRAL REPAIR

What is a shoulder labral tear?

The shoulder labrum is a ring of cartilage that lines the shoulder socket and helps keep the joint stable. It secures the head of the upper arm bone within the socket of the shoulder blade. When this cartilage is damaged, it is known as a labral tear, which may lead to pain, weakness, and a feeling of instability in the shoulder.

What are the symptoms of shoulder labral tear?

A shoulder labral tear may present with:

• Shoulder pain
• Catching, clicking, or locking sensations
• Reduced range of motion
• A feeling of looseness or instability in the joint

What are the types of shoulder labral tears?

The most commonly seen labral injuries include:

SLAP tear

A SLAP (superior labrum anterior to posterior) tear affects the upper portion of the labrum where the biceps tendon attaches.

Bankart tear

A Bankart lesion occurs when the lower part of the labrum is damaged, often associated with repeated shoulder dislocations and an increased risk of joint instability.

Posterior labrum tear

This is a less common injury that may develop due to repetitive internal impingement, where extreme shoulder positioning causes compression and injury to the back portion of the labrum.

How to diagnose a shoulder labral tear?

A diagnosis is usually made based on a combination of symptoms, medical history, and a physical examination assessing shoulder movement and stability. Imaging tests such as X-rays, CT scans, or MRI scans (often with contrast dye) may be used to confirm the diagnosis. In some cases, shoulder arthroscopy is used to directly visualise and confirm the presence of a tear.

Non-surgical (Conservative) Treatment

Initial management often includes rest, anti-inflammatory medication, and a structured rehabilitation programme aimed at strengthening the shoulder muscles. If symptoms persist despite conservative treatment, surgical intervention may be considered.

How is arthroscopic labral repair surgery performed?

The procedure is carried out under general anaesthesia, with the patient positioned to allow optimal access to the shoulder. Small incisions are made around the joint to insert a camera (arthroscope) and specialised surgical instruments.

The camera transmits a live image of the shoulder joint to a screen, enabling detailed assessment of the injury. Damaged tissue is then removed, and the bone surface is prepared to support repair.

The labrum is reconstructed using sutures and small fixation devices known as anchors, which secure the tissue to the bone. In some cases, tissue grafts may be used to rebuild the labrum. Once the repair is complete, the incisions are closed and the shoulder is dressed and supported.

What is recovery like after arthroscopic labral repair?

Following surgery, patients may experience swelling, stiffness, and discomfort around the shoulder. A sling is typically worn for a period of time to protect the joint and limit movement.

Rehabilitation begins gradually, often with physiotherapy to restore strength and mobility. Follow-up appointments are important to monitor healing and recovery progress. Return to work, study, and physical activity depends on individual recovery and will be guided by the treating specialist.

As healing progresses, activity levels are increased step by step, with more demanding movements introduced later in the rehabilitation process.

What are the benefits of arthroscopic labral repair?

• Improved shoulder stability
• Faster recovery compared to open surgery
• Smaller incisions with minimal scarring
• Lower risk of complications
• Improved shoulder function and range of motion