Labral and SLAP Tears
The labrum is a ring of specialized cartilage resting on the outer edge of the socket of the shoulder joint (Figure 1). The labrum serves to deepen the shoulder socket and make it more concave, and the superior labrum is where the long head of the biceps attaches. Furthermore, the labrum helps keep the ball inside the socket.
A labral tear can occur anywhere along its length and frequently tears as a result of injury or shoulder dislocation. It can also tear because of repetitive wear and tear during activities such as repeatedly throwing a ball. Degenerative disease and arthritis can also cause labral tears.
The long head of the biceps attaches on the superior labrum. When this area of the labrum is torn it is called a SLAP tear (Superior Labrum Anterior to Posterior Tear). SLAP tears most often occur in athletes, but they can also occur as a result of injury or overuse. SLAP tears can be the source of great shoulder pain.
Typical treatment for labral tears involves activity modification, anti-inflammatory medications, and physical therapy. When medical treatment fails, arthroscopic repair of the labrum can be performed. Surgical treatment leads to reliable pain relief and a restoration of shoulder function and mobility.
Labral Surgical Repair
Labral surgical repair is suggested for patients with labral tears that do not respond to nonoperative treatment. This procedure is minimally invasive and is done arthroscopically, using a few tiny incisions. Small screws with sutures (suture anchors) are placed in the outer edge of the shoulder socket where the labrum is torn. This ties the labrum down tightly and repairs the tear.
Patients are usually in a sling for 4 to 6 weeks after surgery and may work with a physical therapist for 3 to 6 months. Full activities can usually be resumed within 6 to 12 months.