Arthroscopic Shoulder Stabilisation (Labral Repair)
by dr kalman piper
When a shoulder dislocates for the first time, the labrum (a fibrous wedge of tissue that surrounds the glenoid or shoulder socket) tears off the glenoid. A torn labrum rarely heals correctly and the incidence of re-dislocation is high. A labral tear is diagnosed with an MRI scan. It is not evident on xray, CT or ultrasound scans. If you have a torn labrum, a shoulder stabilisation or shoulder reconstruction surgery may be necessary to prevent recurrent dislocation.
An arthroscopic shoulder stabilisation involves repairing the torn labrum back to the glenoid using keyhole techniques. A series of small incisions or portals are made around the shoulder and a pencil like camera is inserted to look inside the joint. Saline is pumped into the joint so maintain a clear view while performing the surgery.
Once a labral tear is identified, the labrum is “mobilised” or moved back into the correct position adjacent to the lip of the glenoid. The torn labrum is then repaired back to the glenoid using a series of small screws or suture anchors. Each anchor is inserted wholly into the bone and there is no prominence. The anchor has an eyelet, through which passes a strong suture. The suture is tied around the torn labrum, securing the labrum against the bone in the correct location.
The labral repair maintains contact between the labrum and the glenoid in correct anatomical position while the body then heals the labrum back to the bone. While the body is healing the arm is kept immobilised in a sling for a period of 6 weeks. Incorrect stretching of the arm during this time can tear the repair apart, so it is important to follow the correct rehabilitation protocol after your surgery and to wear your sling. During this time in a sling, limited range of motion exercises are performed to prevent the onset of frozen shoulder.
Following six weeks of immobilisation, a rehabilitation program is commenced. Return to contact sports is delayed 6 months to allow time for recover of full shoulder function and the labral repair is as strong as possible.
Any surgical or invasive procedure carries risks. The information provided here is for general educational purposes only. Please contact Dr Kalman Piper to find out if an arthroscopic rotator cuff repair is appropriate for your individual situation.