What is it?
The labrum is a piece of fibrocartilage around the rim of the shoulder that helps to keep the ball of the joint in place. A labral tear is when this labrum is torn which can result from injury or aging. The labrum can tear in a few different ways including completely off of the bone, within or along the edge of the labrum or where the bicep tendon attaches.
In order to properly diagnose, your physician will most likely order a MRI with or without an arthrogram after their physical examination. This helps look into the joint to see how severe the tear is.
What are the treatment options?
Treatment is going to vary on the severity and the location of the tear. If the tear was due to instability of the shoulder, the labrum will need to be reattached to the rim of the socket. If the labrum is frayed, treatment may not be necessary. But, if there is a large tear causing symptoms then the torn part will be either cut out or trimmed or needs to be repaired. If the tear is near the attachment site for the biceps tendon (SLAP lesions), the labrum may need to be trimmed or may need to be reattached to the top of the socket.
Surgical procedures will either be done with either one incision or several small incisions if repairing arthroscopically. This decision is made depending on the location and size of the tear.
What to Expect
Day of Surgery
- Wear comfortable clothes (button down shirt if possible)
- No eating or drinking after midnight for arrivals of noon or before. Otherwise, no eating or drinking 7 hours prior to arrival
- You may resume your regular diet. However, start slow with clear liquids and gradually work your way back to your normal diet. This will help prevent nausea and vomiting.
Shoulder Care & Bathing
- Keep your dressing and sling in place until your first post-op visit, unless instructed otherwise
- Dressing will be changed at your first post-op appointment
- Tegaderm dressing will be placed which will allow you to shower immediately
- No bath or swimming until the bandages are removed
- If the tegaderm dressings become loose or fall off replace with over the counter water proof bandages
- Keep incision dry until sutures are removed
Elevation and Circulation
- Elevate as much as possible for the first 3-5 days, you can achieve this by being seated in a comfortable postion; having extra pillows to support your body, a pillow wedge and/or a recliner are some ways to help you stay relaxed for the first few weeks.
- After these first few days, continue to elevate as needed in order to reduce swelling.
- To encourage circulation and decrease swelling, wiggle your fingers, thumb and wrist several times each hour.
- To help reduce pain and swelling, apply an ice pack to the surgical area for 20 to 25 minutes every one to two hours for the first 48 hours and then as needed to help control pain and swelling.
- To avoid frostbite, place a towel or t-shirt between the ice pack and your skin.
- It is not necessary to use ice while sleeping.
- We recommend the use of a cold therapy unit, which is often an out of pocket expense. The advantage of this unit is that the temperature can be regulated, allowing for continuous use for several hours at a time.
- Your physician will give you a written prescription for pain medicine as you leave the surgery center. Take your pain medication as prescribed. You may want to take it regularly for the first 48 hours after surgery. Do not take any additional Tylenol.
- While you are asleep in the operating room, a long acting numbing medication may be injected into the surgical area to help relieve your immediate postoperative discomfort for up to 24 hours. When you first notice tingling or throbbing, begin taking your pain medicine so it will become effective before the local anesthesia wears off.
- No driving while taking any narcotic pain medication!
- The pain medication may cause some nausea so take it with food.
- The pain medication and general anesthesia may also cause constipation, so you may need to take a stool softener, fiber bar, Metamucil or prune juice to prevent constipation.
- Watch for temperature > 101.5F, persistent numbness and tingling, persistent bleeding or drainage from the wound, foul odor, progressively worsening pain that is unresponsive to pain medication, chest pain or difficulty breathing. If you have any of these symptoms, call the office if during normal business hours or go to the nearest emergency room.
- Please make sure to follow instructions given to you by your physician, they may have specific instructions to your care.
- If you do not have a postoperative appointment set-up already, please call the office to schedule an appointment for 7-10 days after surgery at (785)843-9125.