Sports docs’ weekly blitz: Labral tears of the shoulder

It’s not as commonly seen as an ACL injury, but the term labral tear of the shoulder or the hip is frequently spotted in the sports pages these days. 

Why didn’t we hear of labral tear in the past?

Dr. Greenwald touched on shoulder dislocations in a previous blog and today I will focus on labral tears, which often occur when a shoulder is dislocated. The labrum is a cartilage structure that is located around the edge of the shoulder socket. The labrum deepens the shoulder joint giving it more stability. It also acts as suction cup to keep the ball stabilized in the socket. However, with some dislocations or repetitive stresses to the shoulder, the labrum and its associated ligaments may get detached from the edge of the socket. This creates a laxity in the supportive structures and a path for the ball to dislocate from the socket. Shoulder dislocations are painful and are associated with weakness, not things an effective footballer can play through. 

Why didn’t we hear about labrum tears before?  With open surgery it was difficult to fully appreciate the full anatomy of labrum. Now that most shoulder surgery is done “through the scope” we have the ability to fully evaluate the labrum and its pathology. As surgeons, Drs. Warme, Greenwald and myself have developed skills in arthroscopic repairs and appreciate the significant improvement in our care for athletes. 

With this surgery, sutures through the cartilage labrum and its associate ligaments are driven into the socket bone with special bio-absorbable anchors that securely hold the sutured structure down to bone where they will solidly heal.  Healing takes 3 to 6 months or longer depending on the type of injury. 

Below are photos of an arthroscopic shoulder labral repair. In a future blog, Dr Warme will tell us about hip labral tears and repairs, one of his specialties.