A labral repair is an operation to correct a tear or other serious injury to the labrum, the membrane of fibrous cartilage that covers the outer layer or articular surface of what are called ball and socket joints. This thin and delicate tissue often does not heal well if damaged and can require labral repair surgery and post operative rehabilitation. Labrum injuries are most often associated with shoulder problems common among athletes, but can occur in any ball and socket joint, such as the knee and hip.
There are three types of labral tear that usually require surgical correction. The first is a complete tear of the labrum, where it detaches from the socket and must be reattached, most often as a result of a shoulder dislocation. The second type is a tear within the labrum tissue itself, which causes the membrane to wear away as the ball and socket joint rubs together during normal shoulder motion, a common occurrence as people naturally age. The third type of labral tear can happen in the region where the bicep tendon attaches to the shoulder socket.
The most precise means of diagnosing a labrum injury is through a specialized magnetic resonance imaging (MRI) device known as an arthrogram. A dye is injected into the shoulder joint, which is then scanned by the MRI. If a labral tear is present, the dye will leak out of the affected area. A labral tear is typically difficult to see without this process, and it may be missed by a regular MRI screening.
Labral repair surgery can be performed as a minimally invasive arthroscopic procedure, where the surgeon can examine the shoulder joint with a tiny camera and perform the operation by means of small incisions through the shoulder. If the damage is more extensive, more traditional surgery may be used to perform the labral repair. Once the tear or trauma to the labrum is identified, the surgeon will debride or prepare the labral tissue by cleaning and trimming it, then connect the tissue to the bone by placing tiny anchors, which hold sutures that are then pulled tightly to reattach the labrum to the bone joint.
Within days of labral repair surgery, patients may begin the rehabilitation process to strengthen the effected shoulder area with range of motion and flexibility exercises. This process must proceed with care and under the supervision of a physical therapist to prevent any additional injury and to allow sufficient time for the labrum to fully heal following surgery. Rehabilitation is the final step in the labral repair procedure and is critical to ensure a full recovery. This can take from three to six months to complete.
