Our Summary

This research study compared two methods used in arthroscopic posterior labral repair, a surgical procedure to fix a specific type of shoulder instability. The two methods compared are the knotted and knotless fixation methods. Researchers looked at various databases and selected 17 studies that had relevant information.

They found that the rates of the shoulder becoming unstable again after the surgery were quite low, ranging from 0% to 21%, and the rates of needing another surgery ranged from 0% to 11%. Also, patients generally reported improvement after the surgery, regardless of which method was used, and most were able to return to their normal activities or sports.

In conclusion, both the knotted and knotless methods seem to be effective, with no clear difference between them. However, the researchers noted that the quality of the studies they reviewed was not very high, and there was no standard definition of what counts as a ‘failure’ of the surgery or a recurrence of instability, which makes it hard to draw definitive conclusions.

FAQs

  1. What are the two methods compared in this research study for arthroscopic posterior labral repair?
  2. What were the rates of shoulder instability and the need for further surgery found in the study?
  3. Did the study find a difference in effectiveness between the knotted and knotless methods?

Doctor’s Tip

One helpful tip a doctor might give a patient about labral repair is to follow the post-operative rehabilitation plan carefully. This typically includes physical therapy exercises to help strengthen the shoulder and improve range of motion. It is important to follow these exercises regularly and attend all recommended therapy sessions to ensure the best possible outcome after surgery. Additionally, it is important to communicate any concerns or changes in symptoms to your doctor or physical therapist so they can make any necessary adjustments to your treatment plan.

Suitable For

Patients who are typically recommended for labral repair are those who have shoulder instability, often due to a labral tear or injury. Common symptoms of labral tears include shoulder pain, popping or clicking sensations, weakness, and limited range of motion. Patients who have not responded to conservative treatments such as physical therapy may be candidates for surgery.

Additionally, patients who are active in sports or physical activities that involve repetitive overhead movements, such as athletes or weightlifters, may also be recommended for labral repair to prevent further damage or instability.

Overall, the decision to undergo labral repair surgery is typically made on a case-by-case basis, taking into consideration the patient’s symptoms, activity level, and response to conservative treatments.

Timeline

Before the labral repair procedure, a patient may experience shoulder pain, instability, and limited range of motion. They may undergo imaging tests such as an MRI to diagnose the labral tear and consult with their orthopedic surgeon to discuss treatment options.

After the labral repair surgery, the patient will typically experience some pain and discomfort, which can be managed with pain medication and physical therapy. They will need to wear a sling for a period of time to protect the shoulder and allow it to heal properly. Physical therapy will be an important part of the recovery process to regain strength and range of motion in the shoulder.

Over time, the patient can gradually return to their normal activities and sports, with most patients reporting improvement in their shoulder function. Follow-up appointments with the surgeon will be necessary to monitor the healing process and ensure that the shoulder is recovering well.

What to Ask Your Doctor

Some questions a patient should ask their doctor about labral repair include:

  1. What is the success rate of the surgery in terms of preventing shoulder instability?

  2. What are the potential risks and complications associated with labral repair surgery?

  3. How long is the recovery process and what is the expected timeline for returning to normal activities or sports?

  4. What type of physical therapy or rehabilitation will be required after the surgery?

  5. What are the differences between the knotted and knotless fixation methods, and how will the choice of method affect the outcome of the surgery?

  6. Are there any specific factors about my shoulder instability that make one method more suitable for me than the other?

  7. How many of these surgeries have you performed, and what is your success rate with this procedure?

  8. What is the likelihood of needing additional surgeries in the future after the initial labral repair?

  9. Are there any lifestyle changes or precautions I should take to prevent re-injury or instability after the surgery?

  10. Can you provide me with any additional resources or information about labral repair surgery that can help me make an informed decision about my treatment?

Reference

Authors: DeFoor MT, McDermott ER, Dickens JF, Dekker TJ. Journal: Arthrosc Sports Med Rehabil. 2023 Dec 20;6(1):100837. doi: 10.1016/j.asmr.2023.100837. eCollection 2024 Feb. PMID: 38155813