SHOULDER ARTHROSCOPY

Eric M. Parsons, M.D.

Q: I was told that I have a torn labrum in my shoulder and that I might require surgery. Can you explain what this means?

A:

The glenoid labrum is a rubbery fibrocartilage ring that encircles the socket of the shoulder and provides increased depth and stability to the shoulder joint. Labrum disorders generally come in two forms, those related to the wear and tear effects of normal shoulder use and aging, and those that occur as a result of acute injury.

The labrum can be injured anywhere throughout its course but chronic overuse injury most commonly occurs in the superior aspect where it is a termed a superior labrum anterior and posterior (SLAP) tear. SLAP tears are quite common in those of middle age or older and in this setting may not need surgery. SLAP tears that exist as the result of an injury or that are clearly impairing shoulder function are more likely to require surgical repair. SLAP tears can be elusive to identify even with the use of imaging such as MRI scan and the ultimate diagnosis involves a combination of clinical history, physical examination and imaging tests. The labrum is also injured in cases of acute traumatic shoulder dislocation where the ball becomes separated from the socket. Remarkably, the labrum and the ligaments that attach to it heal adequately following some dislocations and a percentage of patients never require surgical treatment. In many cases, however, the healing of the labrum and shoulder ligaments is incomplete or improperly positioned and surgical repair of the labrum and ligaments is necessary to restore shoulder stability.

Labrum repair is performed arthroscopically through small incisions with the aid of video technology. The technical aspects of instability repair involve placing small screws in the socket where the labrum normally attaches. The screws are called suture anchors and are made from a special form of biodegradable plastic that the body will naturally absorb over time. The suture anchors are armed with high strength sutures that are then placed through the torn capsule and labrum tissue, and through a variety of pulleytype techniques the tissue is returned back to the bone at the location of the anchor.

To view a video of labrum repair visit ohioshouldercenter. com.

Eric M. Parsons, M.D. Ohio Shoulder Center for Arthroscopy Lake Orthopaedic Associates, Inc. 36060 Euclid Ave., Suite 104 Willoughby 440-942-1050 9500 Mentor Ave., Suite 210 Mentor 440-352-1711 www.ohioshouldercenter.com