What is a Shoulder Anterior Labral Repair?
A shoulder anterior labral repair is a surgical procedure performed to address damage or injury to the anterior (front) labrum of the shoulder joint. The labrum is a ring of cartilage that surrounds the shoulder socket (glenoid) and helps stabilize the joint. Injuries to the labrum can occur due to trauma, repetitive overhead motion, dislocation, or other shoulder-related issues.
The anterior labrum is particularly susceptible to injury, and tears or damage in this area can result in instability, pain, and a feeling of the shoulder "catching" or "popping." Anterior labral tears are often associated with specific conditions such as Bankart lesions, which occur when the labrum is detached from the front of the glenoid due to dislocation.
Indications for Shoulder Anterior Labral Repair
If you are a non-athlete, your physician may recommend shoulder anterior labral repair if conservative treatment such as anti-inflammatory medication, injections, and physical therapy have been ineffective in alleviating your symptoms. If you are an athlete and looking to get back on the field, your ideal option will be surgery. Surgery is the ideal way to ensure that your labrum heals correctly.
Preparation for Shoulder Anterior Labral Repair
Preoperative preparation for shoulder anterior labral repair may involve the following steps:
- A comprehensive medical evaluation, routine blood tests, and imaging studies
- Informing your doctor of any allergies to medications, anesthesia, or latex
- Providing your physician with a list of medications or supplements you are taking
- You may need to adjust or temporarily stop taking certain medications - especially those that can affect blood clotting
- Disclosing any recent illnesses or other medical conditions you may have
- Stopping smoking, as it can impact the healing process and increase the risk of complications
- Abstaining from food or drink for at least 8 hours prior to the surgery
- Arranging for someone to drive you home after the surgery
- Signing an informed consent form
Procedure for Shoulder Anterior Labral Repair
The procedure for shoulder anterior labral repair is typically performed arthroscopically, which involves using small incisions and specialized instruments to access and repair the damaged labrum. In general, the procedure involves the following steps:
- You will be placed under general anesthesia to ensure you are unconscious and pain-free during the procedure.
- You will usually be positioned in a semi-seated or lateral decubitus position, depending on the surgeon's preference and the specific details of the case.
- Your surgeon will make 3 to 4 small incisions (arthroscopic portals) ), about half an inch in length, around the shoulder joint to introduce the arthroscope and surgical instruments.
- An arthroscope, a slender tubular device attached with a light and a small video camera at the end is inserted through one of the incisions into your shoulder joint.
- The video camera transmits the image of the inside of your shoulder joint onto a monitor, allowing the surgeon to visualize the labrum and any associated damage.
- Once the damage is identified, your surgeon introduces miniature specialized instruments through other incisions. The surgeon prepares the torn or detached labrum for repair. This may involve removing any damaged tissue or debris to create a clean surface for the repair.
- The surgeon uses specialized instruments to suture or anchor the labrum back to the glenoid bone. Sutures may be passed through the labrum and tied down, or anchors (small devices with sutures attached) may be used to secure the labrum in place.
- After the repair is completed, the surgeon removes the instruments and closes the incisions with sutures or sterile tape.
Postoperative Care and Recovery
In general, postoperative care and recovery after shoulder anterior labral repair may involve the following steps:
- Your arm will be placed in a shoulder sling for 2 to 4 weeks to immobilize the shoulder and promote healing.
- You may experience pain, swelling, and discomfort in the shoulder area. Pain and anti-inflammatory medications are provided as needed to address these.
- Antibiotics are also prescribed to address the risk of surgery-related infection.
- You may also apply ice packs on the shoulder area to help reduce swelling and pain.
- Instructions on incision site care and bathing will be provided to keep the wound clean and dry.
- Avoid strenuous activities and gradually increase daily activities as tolerated.
- A physical therapy regimen will be designed to help strengthen your shoulder muscles and optimize shoulder function.
- You should be able to resume your normal daily activities in 3 to 4 weeks but with certain activity restrictions. Return to sports may take 6 months or longer.
- Refrain from driving until you are fully fit and receive your doctor’s consent.
- A periodic follow-up appointment will be scheduled to monitor your progress.
Risks and Complications
Risks and complications associated with shoulder anterior labral repair include:
- Infection
- Bleeding
- Shoulder stiffness
- Blood clots or deep vein thrombosis (DVT)
- Pain, postoperative and/or persistent
- Injury to adjacent nerves or blood vessels
- Failure of the repair/recurrent instability
