Labral Repair

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.

  • Procedure

  • Why Shoulder Arthroscopy

  • Candidates

  • Recovery

  • Testimonials

Procedure

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.

Frequently Asked

Questions

How long will I need to wear my sling?

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.

Can I drive with a sling on?

You can drive when you feel safe to operate a vehicle with 1 functioning arm. This usually takes most patients a few weeks after surgery.

Do I have to wear the sling at night?

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.

When do I start PT after surgery?

Physical therapy typically starts 2 weeks after surgery.

When can I shower?

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.

How often do I need to use the ice machine?

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.

What is a nerve block?

An anesthetic injection performed by the anesthesiologist to turn off pain signals that go to a targeted region.

How can I control my pain after surgery?

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.

What are the sutures that secure the labrum made out of?

The sutures are made of a high strength non-absorbable material.

What are the risks of a shoulder arthroscopy?

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.

I am told I need surgery. What next?