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Labral Tear Shoulder Surgery Recovery

Problems Associated With Suture Anchors

2 Key Shoulder Labrum Tear Exercises to Avoid Surgery or late SLAP Repair Rehab

Results of arthroscopic labral repair in the early days using staples or bioabsorbable tacks were discouraging, with a 30 % rate of implant-related complications, including loosening, migration, and breakage . However, implant-related complication rates have decreased since the introduction of suture anchors as well as the development of various advanced arthroscopic instruments for secure insertion of the anchor in the glenoid. In a recent report, the failure rate was reported to be 0.3 % . Despite such developments, anchor failures may occur due to technical errors as proper anchor insertion depends on the surgeons technique and experience. In a cadaveric study, Lim et al. demonstrated that the most inferior anchors had a high risk of perforating the inferior cortex of the glenoid when inserted via an anteroinferior portal in the lateral decubitus position. Frank et al. evaluated the effect of portal placement and using a curved drill guide for the inferior suture anchor placement and found that trans-subscapularis portal resulted in the lowest opposite cortex perforation compared to the straight and curved mid-glenoid portal. However, there was no difference in the ultimate load to failure among the three different techniques of inferior anchor placement. The authors prefer labral repair in the beach chair position because the arm is not firmly fixed, which allows more freedom to insert the most inferior anchors compared with that in the lateral decubitus position.

What Is The Labrum

The labrum is a type of cartilage found in the shoulder joint. The shoulder is a ball-and-socket joint where the arm meets the body. The arm bone forms a ball at the shoulder that meets the socket, which is part of the shoulder blade. These two bones are connected by ligaments tough tissues forming tethers that hold the bones in relationship to each other.

There are two kinds of cartilage in the joint. The first type is the white cartilage on the ends of the bones which allows the bones to glide and move on each other. When this type of cartilage starts to wear out , the joint becomes painful and stiff. The labrum is a second kind of cartilage in the shoulder, which is distinctly different from the articular cartilage. This cartilage is more fibrous or rigid than the cartilage on the ends of the ball and socket. Also, this cartilage is also found only around the socket where it is attached.

What Is The Function Of The Labrum

The labrum has two functions. The first is to deepen the socket so that the ball stays in place. Picture the shoulder joint as a beach ball on a dinner plate. The ball of the humerus is much larger than the flat socket . The ligaments are the tethers that go from bone to bone and hold them together to help keep the ball in the socket. The other way the ball is kept in the socket is the labrum.

The labrum is a thick tissue or type of cartilage that is attached to the rim of the socket and essentially forms a bumper that deepens the socket and helps keep the ball in place. In individuals where the labrum is too small or is torn due to an injury, the ball may slide part of the way out of the socket or all the way out of the socket . The labrum goes all the way around the socket and in most areas is firmly attached to the bone of the socket. In some areas it is not firmly attached. Only recently have specialists determined which parts are normal and which parts reflect tearing of the labrum.

The second function of the labrum is as an attachment of other structures or tissues around the joint. For example, the ligaments that help hold the joint together attach to the labrum in certain key locations. If there is an injury to the shoulder that tears the ligaments, sometimes the labrum is pulled off of the rim of the bone as well.

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What Exactly Will Your Surgeon Do During Labral Repair Surgery

After inserting the arthroscope into the incision in the shoulder, your surgeon will remove any scar tissue and prepare the bone of the socket for reattachment. Your surgeon will apply suture anchors to repair your shoulder. The anchors will be inserted into small incisions in the bone. Then, they will add sutures to reattach the labrum to the bone. They hold the labrum in place and can be used to tighten the shoulder joint. Your labrum will heal around these sutures directly to the bone.

Your incisions will be stitched together and your shoulder will be wrapped when you wake up. Your nerve block will still be working for pain relief.

What You Need To Know About Torn Labrum Shoulder Surgery Options

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If youve hurt your shoulder, theres a good chance that you may have torn your labrum. The labrum is an area of cartilage that helps connect your arm to your shoulder, and a tear here can cause pain, weakness, reduced range of motion, and stiffness. If you have a torn labrum, shoulder surgery can be a successful treatment option. On the other hand, a labral tear shoulder injury that isnt causing symptoms usually doesnt require surgical intervention.

The primary job of our team of shoulder specialists is to determine whether you have a labral tear and if it is symptomatic, requiring labrum surgery.

There are several types of labral tears:

  • Those caused by significant trauma, such as a dislocation
  • Those caused by repetitive micro-trauma, like throwing a ball
  • Those caused by normal labral degeneration that occurs with age

Since they usually are not symptomatic, degenerative labral tears are often treated without surgery. However, labral tears caused by trauma, whether a single violent event or multiple smaller events, often do require surgical treatment. Lets take a closer look at your options in these cases.

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Recovery Time For Labrum Surgery

A labrum surgery involves the arthroscopic reattachment of the labram cartilage to the bones of the shoulder joint. Given below is the recovery time and the factors that influence it.

A labrum surgery involves the arthroscopic reattachment of the labram cartilage to the bones of the shoulder joint. Given below is the recovery time and the factors that influence it.

There are two types of cartilage that are present in the shoulder joint the articular cartilage and the labrum. The labrum cartilage is more fibrous or rigid as compared to the articular cartilage present on the ends of the ball and socket joint. Furthermore, it is found to be attached only around the socket. This is a very important cartilage as it serves two functions deepening of the socket so that the ball end of the other bone fits in its place, and to serve as an attachment for other structures or tissues around the joint. This cartilage can get torn in several places, like a small tear within the labrum cartilage, a tear where this cartilage meets the biceps tendon, or a complete tear where there is a subluxation of the shoulder joint. The treatment for a such tears, unless there is only minimal damage, generally involves surgical intervention. An arthroscopic surgery is generally advised to patients to deal with a torn labrum.

What Should You Do Before Surgery To Prepare

It is a good idea to practice doing some activities with one hand. Imagine that your operated arm is in a sling. Practice getting dressed, going to the bathroom, combing your hair, using a hair dryer and driving a car. Can you get out of the car, close the door and get a parking ticket with your arm in a sling?

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Recovery From Shoulder Labrum Tear: What To Expect

The labrum is a piece of cartilage in your shoulder joint that lines the cup where the ball of the long arm bone rests. It helps make the shoulder stable, but it is susceptible to tears in people who often use their arm for overhead motions, such as tennis or baseball players. Older people whose cartilage is more brittle can also damage the labrum. The symptoms of a shoulder labrum tear are pain and reduced range of motion and strength. Depending on the type of tear, you may also have a dislocated shoulder.

Recovery from a labral tear doesnt usually require surgery, but in some instances, an operation will help restore maximum arm and shoulder function. Heres what to expect when you are recovering from a labral tear.

Diagnosing A Labral Tear

shoulder surgery labral tear – what to expect truth

You doctor will ask you if you remember a certain point at which the pain began. If clinical signs of a labral tear are present in your shoulder he or she will likely order an MRI arthrogram to detect a labral tear since X-rays cannot detect soft tissue injury.

Your doctor will perform physical examination that checks for range of motion, instability and pain. Ultimately, your doctor will rely on arthroscopy for final diagnosis and treatment.

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Whats The Recovery Time For Labrum Surgery

Labral tears are injuries to the disc of cartilage that surrounds the ball-and-socket shoulder joint. These injuries are usually the result of long term wear and tear, participation in athletics like baseball or weightlifting, or accidents dealing with automobile crashes or falls.

Depending upon the degree of the injury, surgery could be minimally invasive or more aggressive, which would dictate the exact recovery time from surgery. However, we can look into what the recovery looks like and figure out from there what a realistic timeline might be:

Anywhere from 2-4 weeks after surgery, youll likely be advised to wear a sling on the arm. This should keep your shoulder in place and prevent trauma during your recovery. It may be difficult to perform every day tasks during this phase, like driving, writing, or doing dishes, depending if surgery was done on your dominant arm or not. You should prepare to have some help during this recovery time.

After the initial healing period, physical therapy may be recommended as the next course of treatment. Your physical therapist will likely design a program around building and regaining strength, flexibility, and range of motion. It can take anywhere between 4-6 weeks to build up enough strength in the shoulder to go back to regular every day activity.

Looking for a physical therapy center to recover from labrum surgery? MedAmerica Rehab can help reach out to us today about your first consultation.

Labral Tear Shoulder Surgery: Debridement

Some labral tears cause symptoms because the torn labral tissue irritates the capsule or adjacent lining of the joint. In other cases, the torn tissue catches in the joint when the shoulder moves.

If the shoulder tissue is significantly damaged, or if the bulk of the labrum is attached to the glenoid , leaving just a flap or small free piece of the labrum intact, debridement is typically the most effective shoulder labrum surgery option.

What Is Debridement?

During debridement, the torn labral tissue is removed arthroscopically using a motorized shaver or scissor-like instruments. Although this reduces the total amount of remaining labral tissue, the torn tissue was incapable of doing its job, so removing it eliminates the symptoms without further decreasing shoulder function. One way to think of debridement is that its similar to clipping a hangnail.

In many cases, the bulk of the labrum remains attached to the glenoid, as do the shoulder ligaments. Consequently, the shoulder maintains stability and has full function.

What Is Recovery Like After Debridement?

Since the tissue is not repaired or reattached to the glenoid, there is no need to protect it after surgery. Most patients use an arm sling for comfort for a few days. Physical therapy can start immediately, and there are no restrictions on activity other than those due to your pain.

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Heres What To Expect During Your Hip Labral Tear Recovery: A Timeline Overview

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Your hip is a ball-and-socket joint comprising the femoral head, the topmost part of your thighbone , and the acetabulum, the socket part of the hip joint. A soft tissue called the labrum covers the acetabulum and allows the femoral head to move smoothly within it.

When the labrum tears, your hip joint loses lubrication, making it difficult or even painful for you to move. You may also experience stiffness in the hip, pain that increases with prolonged sitting, or deep pain in the front of your hip. Many factors can cause this condition to develop, such as structural ailments, hip injuries, and degenerative health conditions.

While not all hip labral tears require surgery, doctors may recommend such a procedure if more conservative treatment options fail to bring you labral hip pain relief.

To help give you a holistic overview of hip labral tear recovery, the sections below will provide you with some insight into the labral repair protocol and answer frequently asked questions about labral tear treatment.

How Should I Care For My Shoulder After Surgery

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Prior to your discharge, you will be given specific instructions on how to care for your shoulder. In general, you can expect the following:

Bandage:You will have a thick dressing on your shoulder. The physical therapist will take off your dressing on your first therapy visit, 2-3 days after your surgery. You may get the shoulder wet after the dressing is removed.

Diet:Resume your regular diet as soon as tolerated. It is best to start with clear liquids before advancing to solid food.

Medication:You will be given medication for pain before you go home.

Sling:You will have a sling, which you will use for the first 2-4 weeks. You can remove the sling for showering and performing your home exercise program.

Ice:You may be given a continuous cold therapy unit for your shoulder. It is a pad that sits on your shoulder and provides cold to your shoulder. If you dont have a therapy unit, apply ice over the dressing for 30 minutes every 1-2 hours for several days. Do not use heat the first week after surgery.

Suture Removal:In general, there are no sutures that need to be removed. The surgeon uses absorbable sutures to close the small incisions. Occasionally, there are non-absorbable sutures and they will be removed on your first post-op visit.

Follow-up office visit:You will be instructed on when to follow-up in the office. This is usually 2 weeks after surgery.

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Three Stages Of Recovery

The first stage of recovery can be described as The Acute Pain Stage. During this period, you can expect difficulty when sleeping. It usually does take about 4-6 weeks, during which time formal physical therapy is encouraged.

The second stage could be classified as The Strengthening Stage. Both stretching and strengthening exercises will bring mild discomfort. Many patients report that they still feel as if dislocation is imminent, and often they hear cracking in their shoulders. The reason for those issues is that the surgery probably tightened the joint, causing minor unfamiliar pressure on the repaired tissues that feeling will continually lessen, as time goes on.

Ranging from 12-16 weeks, this stage opens the door to The Transitional Stage. During that third stage, which can range from 6-12 weeks, most patients report that they feel normal again. If it takes you almost an entire year to truly feel that way, thats within the range of normal, too.

As you recover from shoulder labral repair surgery, frustration can easily accompany you on the journey. But as you become educated and achieve realistic expectations, you will be more apt to take your time, inching slowly but steadily toward full recovery.

When Can I Return To Sports

In general, you will be allowed to return to sports in 4-6 months after surgery. You must have good motion, strength, and control of your shoulder and arm. How quickly you return to sports depends on several factors, including:

  • Your own rate of healing
  • The damage found at surgery
  • If you have any complications
  • How well you follow the post-operative instructions
  • How hard you work in rehabilitation
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    Surgery For Shoulder Labral Tears

    NYU Langone doctors may recommend surgery to repair a shoulder labral tear if nonsurgical treatments such as physical therapy have not helped the injury heal.

    Surgery for a shoulder labral tear usually takes an hour and is an outpatient procedure. Our fellowship-trained, internationally known orthopedic surgeons typically use arthroscopic surgery, also called arthroscopy, which is performed through three or four small incisions, rather than one large open incision. Smaller incisions allow for more-rapid healing and recovery. A tiny camera, inserted through one of these incisions, enables doctors to view your shoulder joint, the damaged labrum, nearby ligaments, and the surgical repair.

    After surgery, you may need to wear an arm sling, which helps rest the shoulder, for about four to six weeks. Physical therapy is also an important part of your recovery.

    When Can You Return To Routine Activities

    Failed shoulder labral tear surgery: How Trevor recovered from a bad shoulder

    You will be able to use your fingers, wrist and elbow immediately after surgery. You may walk with assistance as soon as you have recovered sufficiently from anesthesia. If you live alone it may be helpful to have someone stay with you for 1-2 days. You may shower or bathe with regular soap and water 48 hours after surgery. Bend from the waist and let your operated arm move away from your side then use your good arm to wash under your armpit. Some patients find it helpful to put a plastic stool or chair in the shower for a day or two. Remember that you are doing everything with one hand. You may walk outdoors, write, cook, and drive a car within a few days. Connecting the seat belt is awkward. Take your time and move slowly. Do not lift more than 1-2 pounds with your operated arm.

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