Our Summary

This research paper is about an innovative surgical technique to treat severe injuries to a part of the shoulder called the ‘glenoid labrum’. When this part is damaged due to repetitive instability or a first-time dislocation, it can cause chronic shoulder pain and instability. The injuries are often hard to diagnose as the symptoms can vary and may not respond to usual treatment methods.

The paper discusses a method of arthroscopic repair, which is a minimally invasive surgical procedure. This method has shown good results, with patients reporting positive outcomes, a low rate of procedure failure, and a high rate of returning to sports activities.

The authors discuss the use of a special device called a ‘knotless suture anchor’ that holds the repaired tissues together. This device is as effective as traditional methods but avoids some of the risks associated with them, such as the loosening or migration of the knot, or abrasion of the joint. It also makes the surgery quicker and easier to perform.

The main focus of the paper is to explain their preferred method for treating a specific type of labrum tear using this knotless anchor repair technique.

FAQs

  1. What are the symptoms of extensive glenoid labral tears?
  2. How effective is arthroscopic repair in treating glenoid labral tears and what are the benefits of knotless suture anchors?
  3. Can you describe the preferred method for treating a 270° labral tear?

Doctor’s Tip

A doctor might tell a patient undergoing labral repair surgery to follow post-operative rehabilitation protocols carefully, which may include physical therapy to help regain strength and range of motion in the shoulder. It is important to follow all instructions provided by the medical team to ensure a successful recovery and to minimize the risk of re-injury.

Suitable For

Patients who are typically recommended labral repair are those with extensive glenoid labral tears that compromise the mechanical stability of the glenohumeral joint. These tears can result from repetitive instability or first-time dislocation and can lead to recurrent multiplanar instability and pain that does not respond to conservative management. These patients may have difficulty with diagnosis due to variability in clinical presentation and advanced imaging findings. Arthroscopic repair techniques, using knotless suture anchors, have shown positive outcomes in terms of patient-reported outcomes, low failure rates, and high return-to-sport rates. This technique can be used to treat a 270° labral tear and other extensive labral pathologies.

Timeline

Before labral repair:

  • Patient experiences recurrent shoulder instability and pain that is nonresponsive to conservative management
  • Difficulty in diagnosis due to variability in clinical presentation and advanced imaging findings

After labral repair:

  • Positive patient-reported outcomes
  • Low failure rates
  • High return-to-sport rates
  • Improved mechanical stability of the glenohumeral joint
  • Reduced risk of complications associated with knotted suture anchors
  • Easier placement and decreased operative time with knotless suture anchors

What to Ask Your Doctor

  1. What is a labral tear and how does it affect the stability of the shoulder joint?
  2. How will I know if I have a labral tear and what are the common symptoms?
  3. What are the potential risks and benefits of undergoing labral repair surgery?
  4. What is the success rate of arthroscopic knotless anchor repair for labral tears?
  5. How long is the recovery period after labral repair surgery and what is the rehabilitation process like?
  6. Are there any specific activities or movements I should avoid after surgery to prevent re-injury?
  7. What are the expected outcomes in terms of pain relief and functional improvements after labral repair surgery?
  8. Are there any alternative treatment options to consider before deciding on surgery?
  9. How many surgeries of this type have you performed and what is your success rate?
  10. What can I do to prevent future labral tears or shoulder instability after surgery?

Reference

Authors: Comfort SM, Peebles AM, Ruzbarsky JJ, Akamefula RA, Provencher MT. Journal: Arthrosc Tech. 2021 Sep 21;10(10):e2319-e2324. doi: 10.1016/j.eats.2021.07.037. eCollection 2021 Oct. PMID: 34754740