Arthroscopic shoulder surgery is a procedure using a small camera device (called an arthroscope) to examine and correct any damages to the shoulder joints or tissues. This technique is less invasive than open shoulder surgery, as the arthroscope is inserted into a small incision rather than opening a large surface area. When used in combination with glenohumeral debridement, arthroscopic shoulder treatment for a labral injury has shown good results.
The shoulder has three main bones: the humerus (upper arm bone), the clavicle (collarbone
e), and the scapula (shoulder blade). The head of the humerus rests in a shallow socket called the glenoid. This socket is has a soft fibrous tissue rim called the labrum, which surrounds the socket and stabilizes the shoulder joint.
With posterior shoulder instability, the mechanism of injury can be from trauma or from repetitive overuse. Therefore, the symptoms of the study participants varied, with many complains. However, all participants were eager to return to their previous activity level and continue playing sports.
The Labrum Repair Procedure
The portion of the cartilage called the labrum gives the shoulder the ability to move in a full range of motion. When there is a tear in this structure, it is called a labral tear. The most common injury to the shoulder labrum is referred to as a SLAP tear (short for Superior Labrum Anterior Posterior).
Many of these injuries can be treated with conservative treatment, such as medications and physical therapy. Other times, however, surgical repair is necessary to repair the torn labrum.
By planning before operating, the need for additional access portals to the joint is not necessary. A simple technique can be used for posterior labral repair with the use of capsular plications. This technique will allow the surgeon to repair the capsular laxity and posterior labral tears without any accessory portals.
During labral repair surgery, the Phoenix orthopedic specialist uses an arthroscope to view the tear. The tiny camera is inserted through a small incision made at the area of injury. This allows the doctor to view the inside of the shoulder on a TV monitor. The doctor must also insert tiny instruments through other small incisions to make necessary repairs.
After repairing the damage, the surgical site is closed with sutures (stitches), and a dry, sterile dressing is applied. The recovery time will depend on the extent of the tear, the type of injury, the surgical procedure, and the health of the patient. Most people usually require around two to three months of rehabilitation following arthroscopic labral surgery.
Risk Factors for Shoulder Labral Injury
Injuries to the shoulder socket and surrounding tissues often occur from repetitive shoulder activity or from acute trauma. Examples of traumatic injury are:
- A direct blow to the shoulder
- Falling onto an outstretched hand
- A sudden pull during lifting
- A violent overhead reach, such as attempting to stop a slide or fall
Different Types of Labral Tears
Symptoms of a Shoulder Socket Rim Tear
- Catching, grinding, locking, and/or popping
- Pain with overhead activities
- A sense of shoulder instability
- Loss of strength
- A decrease in range of motion
Recovery and Rehabilitation
After surgery, the patient is placed in a sling that allows 30 degrees of external rotation for six to eight weeks. After this time frame, the patient can use a standard sling. Physical therapy is recommended four weeks after the procedure. The patient should avoid specific posterior capsular stretching for three months following the procedure, but shoulder range of motion exercises are encouraged. Recovery usually takes six to eight months.
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