The labrum is a critical part of both your shoulder and hip joints. Think of it like a rubber seal or gasket that lines the socket of the joint. It helps to deepen the socket, providing stability and allowing for a smooth range of motion. When this tissueis torn, it can be a significant source of pain and can affect your ability to perform everyday activities and lead to symptoms of instability
- Shoulder Labral Tears: These are common, especially in athletes who perform overhead motions, such as baseball players, swimmers, and tennis players. They can also occur from a fall or other traumatic injury. Labral tissue is also commonly degenerated as individuals age
- Hip Labral Tears: These are often seen in athletes who participate in sports that involve twisting and pivoting, such as soccer, hockey, and ballet. They can also be caused by structural problems in the hip joint, such as femoroacetabular impingement, or FAI
Depending on the severity of the tear and your individual circumstances, your doctor may recommend either a labral repair or a labral reconstruction.
- Labral Repair: This is the most common surgical treatment for a labral tear. The goal is to reattach the torn labrum to the bone of the socket. This is typically done using small anchors and sutures.
- Labral Reconstruction: In some cases, the labrum may be too damaged to be repaired. When this happens, your surgeon may recommend a labral reconstruction. This involves replacing the damaged labrum with a tissue graft. The graft can be taken from another part of your body (autograft) or from a donor (allograft).
Why is Labral Surgery Done?
The main reason for labral surgery is to relieve pain and improve the function of your shoulder or hip. If you have a labral tear, you may experience:
- A deep, aching pain in the joint
- A clicking, catching, or locking sensation
- A feeling of instability, as if the joint is going to “give way”
- A decreased range of motion
If these symptoms are not relieved by conservative treatments, such as rest, physical therapy, and anti-inflammatory medications, your doctor may recommend surgery. The goals of surgery are to:
- Restore stability to the joint
- Relieve pain
- Improve your range of motion and function
- Prevent further damage to the joint
What to Expect
Before the Procedure
Before your surgery, you will have a thorough evaluation with one of our orthopedic surgeons. This may include a physical exam, X-rays, and an MRI to confirm the diagnosis and assess the extent of the tear. You will also meet with our anesthesia team to discuss your medical history and develop a safe and effective anesthesia plan.
During the Procedure
Labral repair and reconstruction are typically performed arthroscopically. This is a minimally invasive technique that uses a small camera, called an arthroscope, to see inside the joint. The surgeon makes several small incisions around the joint and inserts the arthroscope and other small surgical instruments.
- For a labral repair, the surgeon will use the instruments to reattach the torn labrum to the bone of the socket using small anchors and sutures.
- For a labral reconstruction, the surgeon will remove the damaged labrum and replace it with a tissue graft. The graft is then anchored to the bone of the socket.
Arthroscopic surgery has several advantages over traditional open surgery, including:
- Less pain
- Less scarring
- A faster recovery
After the Procedure
After your surgery, you will be taken to the recovery room where you will be monitored by our nursing staff. You will likely be able to go home the same day. You will be given a sling to wear to protect the joint (for a shoulder labral repair) or crutches to protect weightbearing in a hip labral repair, and you will be given instructions on how to care for your incisions.
Physical therapy is a critical part of your recovery. You will work with a physical therapist to regain your range of motion, strength, and function. The length of your recovery will depend on the extent of your surgery and your individual progress, but most people are able to return to their normal activities within a few months.
Common Symptoms and Causes of Labral Tears
Symptoms
The symptoms of a labral tear can vary depending on the location and severity of the tear. Common symptoms include:
- A deep, aching pain in the joint
- Pain that worsens with certain activities, such as overhead motions or twisting
- A clicking, catching, or locking sensation
- A feeling of instability
- A decreased range of motion
- Stiffness in the joint
Causes
Labral tears can be caused by a variety of factors, including:
- Trauma: A fall, a direct blow to the joint, particularly those leading to dislocation of the joint, or a sudden twisting motion can cause a labral tear.
- Overuse: Repetitive motions, such as those seen in certain sports, can lead to a gradual tearing of the labrum over time.
- Structural abnormalities: Some people are born with structural problems in their hip or shoulder that can increase their risk of a labral tear.
Common Risk Factors for Labral Tears
Certain factors can increase your risk of a labral tear, including:
- Age: The labrum can become more brittle and prone to tearing as you get older.
- Activities: Participating in sports that involve repetitive overhead motions or twisting can increase your risk.
- Previous injuries: A previous shoulder dislocation or other joint injury can make you more susceptible to a labral tear.
- Bone abnormalities: Certain bone structures in the hip, such as femoroacetabular impingement, or FAI, or shoulder can increase the stress on the labrum.
At California Pacific Orthopaedics, our goal is to provide you with the highest quality of care in a compassionate and supportive environment. If you are experiencing symptoms of a labral tear, we encourage you to schedule a consultation with one of our orthopedic specialists. We will work with you to develop a personalized treatment plan to help you get back to a pain-free and active life.
