Our Summary

This research paper discusses a technique for repairing a specific type of shoulder injury. The glenoid labrum is a ring of fibrocartilage (rubbery tissue) around the edge of the glenoid cavity in the shoulder blade, which can be damaged and cause pain and instability in the shoulder. The paper focuses on a particularly challenging type of injury known as a pan-labral tear, which involves a tear going all the way around the labrum.

The paper suggests that to repair such an injury, surgeons need to access all parts of the labrum from various angles. This involves using additional entry points (accessory portals) and minimally invasive techniques (percutaneous techniques). The procedure also requires careful planning during the operation to ensure the labrum and the tissue around it are properly aligned and tensioned. The aim of the article is to explain this technique and emphasize the need for these additional methods to access the whole glenoid.

FAQs

  1. What is the glenoid labrum and how can injuries to it cause shoulder instability and pain?
  2. What are the challenges in repairing a pan-labral or circumferential (360°) tear of the glenoid labrum?
  3. What techniques are used in the repair of a pan-labral lesion of the glenoid labrum?

Doctor’s Tip

One helpful tip a doctor might tell a patient about labral repair is to follow the post-operative rehabilitation plan closely. This may include physical therapy exercises to strengthen the muscles around the shoulder joint, as well as avoiding certain movements or activities that could put strain on the repaired labrum. Following the rehabilitation plan can help ensure proper healing and reduce the risk of re-injury.

Suitable For

Patients who are typically recommended labral repair are those who have sustained injuries to the glenoid labrum resulting in shoulder instability and pain. This includes individuals with pan-labral or circumferential tears of the glenoid labrum, which can be a challenging injury to treat even for experienced arthroscopists. These patients may require the use of accessory portals and percutaneous techniques to properly visualize and repair the extensive lesion. Intraoperative planning is crucial to ensure proper tensioning and alignment of the labrum and capsular tissue during the repair process.

Timeline

Before labral repair:

  1. Patient experiences shoulder instability and pain.
  2. Imaging tests such as MRI may be done to diagnose the labral tear.
  3. Consultation with an orthopedic surgeon to discuss treatment options.
  4. Preoperative preparation including physical therapy and medications for pain management.

After labral repair:

  1. Surgery is performed using arthroscopic techniques to repair the labral tear.
  2. Postoperative recovery period involves physical therapy to regain strength and range of motion.
  3. Follow-up appointments with the surgeon to monitor healing progress.
  4. Gradual return to normal activities and sports, with restrictions as advised by the surgeon.
  5. Long-term follow-up to monitor for any recurrent instability or pain.

What to Ask Your Doctor

  1. What is a labral repair procedure and how is it performed?
  2. What are the potential risks and complications associated with labral repair surgery?
  3. How long is the recovery process after labral repair surgery?
  4. What type of physical therapy or rehabilitation will be required after the surgery?
  5. Will I need to modify my daily activities or sports participation after the surgery?
  6. How successful is labral repair surgery in relieving shoulder pain and improving shoulder stability?
  7. Are there alternative treatment options to consider before proceeding with labral repair surgery?
  8. How many labral repair surgeries have you performed and what is your success rate?
  9. What is the expected outcome of the surgery in terms of pain relief and shoulder function?
  10. How long will the results of the labral repair surgery last?

Reference

Authors: Rao AJ, Cvetanovich GL, Zuke WA, Low Q, Forsythe B. Journal: Arthrosc Tech. 2017 Jul 31;6(4):e1131-e1136. doi: 10.1016/j.eats.2017.03.034. eCollection 2017 Aug. PMID: 29354408