Arthroscopic Labral and SLAP Tear Surgery

What is a labral tear and how does it affect shoulder instability?

The shoulder and hip are ball and socket joints within the human body. Each of these joints have a protective cuff of cartilage called a labrum. The labrum in the shoulder is responsible for stabilizing the joint by deepening the socket of the shoulder which holds the humerus (upper arm bone) securely in the glenoid (socket). This secure, yet flexible fit of the humerus within the glenoid allows an incredible range of motion for the shoulder joint. A tear in the labrum can cause weakness and instability within the shoulder joint. Labral tears can limit the range of motion, lead to pain and recurrent shoulder dislocations. Dr. Benedict Nwachukwu, orthopedic shoulder surgeon, serving patients in Manhattan, New York City and the surrounding New York boroughs has extensive experience in helping patients with labral and slap tears.

What is a SLAP tear?

A SLAP tear is another type of tear in the labrum which specifies the location of the tear. SLAP is the acronym for Superior Labrum Anterior and Posterior, which means the tear is located at the top of the shoulder socket and involves the attachment site of the biceps tendon. Pain from a SLAP tear is typically felt deep within the shoulder, commonly in the front and will worsen when moving the shoulder through its normal range of motion.

What is a Bankart tear?

Also called a Bankart lesion, this specific type of labrum tear is named for the English orthopedic surgeon, Arthur Sydney Blundell Bankart, who first described the lesion and the “Bankart Repair” for shoulder dislocations. A Bankart tear is an injury to the anterior (inferior) glenoid labrum, meaning the lower portion of the labrum, in the front part of the shoulder. This area of the labrum is an important attachment site for the inferior glenohumeral ligaments which stabilize the shoulder. When torn, patients may feel as if their shoulder will dislocate, or move out of place, especially with rotation. Bankart tears typically occur with a shoulder dislocation. The head of the humerus is forced toward the front of the body, causing the lower portion of the anterior labrum to tear. This is commonly seen in sports collisions or falls.

Do labral and SLAP tears require surgery?

The decision to repair a labral or SLAP tear is dependent upon a number of factors, including the size, location, type of tear and other associated shoulder injuries. The mechanism of injury also plays a role in the decision for surgical repair as well as patient age and level of activity.  Older patients who are experiencing a degenerative tearing of the labrum, often a normal consequence of aging, do not typically require surgical intervention. Younger patients with larger tears or labral tears associated with a dislocation and subsequent shoulder instability that have not responded to previous non-surgical treatment typically prefer a surgical repair option.

Patients in Manhattan, New York City and the surrounding New York boroughs have the option of arthroscopic labral and SLAP tear surgery from Dr. Benedict Nwachukwu, orthopedic shoulder surgeon. Arthroscopic labral and SLAP tear surgery, also called minimally invasive surgery, uses a small camera and small instruments to treat and repair the tear within the shoulder joint.

What is Arthroscopic Labral and SLAP tear surgery?

During this minimally invasive procedure, the torn labrum is visualized with a small camera, called an arthroscope, which is inserted in to the shoulder through a small incision. The camera displays the image onto a screen where Dr. Nwachukwu can see the extent of the damage to the labrum. Small surgical instruments, inserted through equally small incisions, are used to clean up scar tissue, rough edges and to prepare the glenoid socket for the reattachment of the labrum. Arthroscopic labral and SLAP tear surgery offers patients in New York quicker healing times, less risk for infection and less post-operative pain.

What is done during arthroscopic labral and SLAP tear surgery?

Once Dr. Nwachukwu has visualized the torn labrum and cleaned up the glenoid with the specialized arthroscopic camera and instruments, he will reattach the torn labrum to the bone. This is done by using special implants called suture anchors which are inserted into the glenoid bone. Each anchor has a suture that is used to reattach the labrum back to the bone and hold it securely. Depending on the size and type of tear, multiple suture anchors may be used to hold the labrum in place and to tighten the torn or stretched ligaments. It is important for the labrum to heal directly to the bone, in its original anatomical position. This will help the patient to avoid future shoulder instability and labral or SLAP tear problems.

What occurs after labral tear repair?

Patients can expect the following after the arthroscopic repair of the labrum:

• Patients will be placed in a sling to keep the arm and shoulder immobile. Typically, this can be for approximately 3-6 weeks, as determined by Dr. Nwachukwu.
• Pain medication is prescribed to be taken as directed.
• Passive range of motion exercises will begin in the first week following surgery.
• Active range of motion exercises will begin once Dr. Nwachukwu has seen proper healing of the labrum.
• Physical therapy, as directed by Dr. Nwachukwu and his team can begin around 6 weeks, with gradual strengthening exercises as tolerated.

For additional resources about arthroscopic labral and SLAP tear surgery, or to have your shoulder pain or shoulder instability evaluated, please contact the office of Benedict Nwachukwu, MD, orthopedic shoulder surgeon serving Manhattan, New York City and surrounding New York boroughs.