Labral Repair and SLAP Repair / Biceps Tenodesis
There are various types of labral tears which are classified according to the location of the tear. When the labrum gets torn, the best treatment option is usually surgery because the labrum typically does not heal on its own. The labrum is usually repaired with minimally invasive techniques like a shoulder arthroscopy.
Why Shoulder Arthroscopy
A shoulder arthroscopy is the traditional treatment for labral repair. It is a minimally invasive procedure that includes creating a few small incisions (roughly 0.5 inch each) around the shoulder joint. These small portals allow a camera to enter the joint for visualization of anatomic structures, as well as tools to repair any injured structures. If the labrum is torn on the front or back of the glenoid (socket), the suture will be passed around the labrum and reattached to the glenoid with an anchor that is inserted into the bone. A tear at the top of the glenoid is called a SLAP (superior labrum anterior posterior). Since the long head of the biceps tendon attaches to this part of the labrum, treatment of this type of tear often involves releasing the biceps from the labrum and attaching it to the upper arm. This is called a biceps tenodesis.
- This surgery is most often performed under general anesthesia with a nerve block, but can be performed with a nerve block and sedation.
- This surgery is usually outpatient, which means the patient will be able to go home the same day.
- Surgery typically lasts 1-1.5 hours.
- Patient will be fit for a sling at a preop appointment before surgery and will need to bring this to surgery.
- The sling will be placed on the patient prior to waking up from anesthesia.
- The incisions will be closed with absorbable suture with dressings that can be removed 2-3 days after surgery.
Why Shoulder Arthroscopy for a Torn Labrum
- Decreases shoulder pain that was caused by the tear
- Restores shoulder range of motion and function
- Regain shoulder strength
- Eliminate shoulder instability events
- Decrease/eliminate shoulder catching or popping sensation
- Return to work, sport, and activities with confidence
- Patients who have failed conservative treatment of anti-inflammatories, observation, or physical therapy
- Patients who have persistent pain
- Patients with recurrent shoulder dislocations or subluxations
- Patients who want to return to work, sport, and activities with pre-injury potential
Most frequently, patients will be placed in a sling for 4 weeks postop. For the first several weeks, activities are limited to elbow range of motion and pendulum exercises. Physical therapy (PT) will start 2 weeks after surgery. Physical therapists follow a prescribed protocol outlined by Dr. Faulkner to regain range of motion and strength. Physical therapy and home exercises are a critical part of a patient’s outcomes and quality of life after surgery.The patient should expect to continue to improve with range of motion and strength up to 1 year after surgery, with most of the gains occurring within the first few months. The patient should plan on being seen in clinic about every 6 weeks until 4-5 months after surgery for close monitoring and to ensure any questions are answered.
I was referred to Dr. Faulkner by my general doctor and I am so glad she made this recommendation. It was discovered I had a 270 degree SLAP injury but surgery was postponed by a little over two months due to the COVID outbreak.
My surgery went without a hitch and my recovery time was ahead by 4-6 weeks. I had no problems out of surgery and was out of the sling in a week. The pain was tolerable and I was off of the “hard” medicine within 3 days. Oh by the way my age is not that young; I am 57 years old and I had this quick recovery which I attribute to the doctor’s skills.
I would recommend Dr. Faulkner not only because of his great surgical skills, he has an amazing positive attitude and always has a smile.
shoulder arthroscopy, labral repair, biceps tenodesis
Dr. Faulkner performed surgery on my shoulder in mid 2018 where he repaired 90% of my shoulder’s labrum. Being 43 years old, doing a ton of research on this type of surgery where a labrum was that torn, I had my doubts that I would ever be able to make a full recovery. Because of Dr. Faulkner’s great work, not only was I able to make a full recovery, but I came out stronger than before. After following the Dr.’s orders and doing my my rehab religiously, I now hold the US National Record for Deadlifting and sit 3rd in the world for my age and weight class. This would not be possible without Dr. Faulkner’s skillset during my surgery. In addition, Dr. Faulkner is such a great, caring doctor and I truly believe that he finds joy in helping people heal and reach their full potential by living injury free.
shoulder arthroscopy and labral repair
I came to Dr. Faulkner after having unexplained, severe shoulder pain for quite some time. I was incredibly pleased with how he cared for me, from initial consultation to diagnosis and finally through a posterior labral repair surgery. I have to say, I was nervous to undergo the procedure, but his professionalism and extensive knowledge led to reassurance with the whole process. I was provided with realistic expectations and all of my questions were answered, knowing that recovery would take some time. After 6 months post-surgery, I can say that I regained full mobility of my shoulder which I haven't had for years. My successful surgery and recovery were all thanks to Dr. Faulkner and his entire team. I couldn't have asked for a better outcome or a more skilled surgeon.
posterior labral repair
4 weeks. The sling should be removed at least 3x/day for elbow, wrist, and finger range of motion exercises as will be instructed. You should do pendulum exercises 3x/day as well.
No. Driving with a sling is considered driving impaired and could be subject to a citation.
Yes. Patients are usually unaware of their arm movements at night. The sling helps to ensure that the arm stays in a good position for healing.
Physical therapy typically starts 2 weeks after surgery.
2 days after surgery. Once you remove the bandages, you will see 3 sticky white strips covering the wounds. These are called steri-strips and should be left in place until your first postoperative appointment.
The ice machine should be used for about 30 minutes at least 3 times a day until your first postop. You may ice more frequently if desired.
An anesthetic injection performed by the anesthesiologist to turn off pain signals that go to a targeted region.
This will be discussed at your preop appointment. If a narcotic is prescribed, the risks and side effects will be reviewed with you. We encourage you to try and discontinue these by your first postop appointment. Depending on your health history, it is encouraged to take anti-inflammatories and Tylenol instead of the narcotics.
The sutures are made of a high strength non-absorbable material.
The overall risk of a complication is less than 1%. The most common risk is shoulder stiffness from scarring. Other more rare risks include infection, bleeding, and persistent pain.