What is a Labral Tear? How is it Repaired?

The labrum is a ring of fibrocartilage that surrounds the glenoid (socket) of the shoulder, providing stability and serving as an attachment point for ligaments and the biceps tendon. A labral tear occurs when this cartilage ring is damaged, which can lead to instability, pain, and mechanical symptoms in the shoulder.

The most common types include SLAP tears (Superior Labrum Anterior to Posterior), which affect the top of the labrum where the biceps tendon attaches, and Bankart lesions, which involve the lower front portion of the labrum and are commonly associated with shoulder dislocations. Posterior labral tears can also occur, particularly in athletes.

Symptoms may include a deep ache in the shoulder, catching or locking sensations, pain with overhead activities, and a feeling of instability. Diagnosis involves physical examination with specific labral tests, and MRI arthrography (MRI with contrast dye injected into the joint) is the most sensitive imaging study for detecting labral tears.

Labral repair is performed arthroscopically, using small incisions and a camera to visualize the joint. The torn labrum is reattached to the glenoid rim using suture anchors. For patients with recurrent instability, additional ligament tightening (capsulorrhaphy) may be performed. Recovery involves sling immobilization followed by a structured physical therapy program.