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Shoulder

Arthroscopic Labrum Repair

Arthroscopic labrum repair is a minimally invasive shoulder procedure used to restore stability and function when the labrum is torn. The labrum is a ring of cartilage that surrounds the shoulder socket, helping keep the ball of the upper arm securely in place. When this structure is damaged, the shoulder can feel unstable, painful, or prone to repeated dislocations. This procedure uses small instruments and a camera to repair the torn tissue without the need for large incisions.

For patients treated by Dr. David Gazzaniga, arthroscopic labrum repair is a precise, evidence-based solution designed to restore shoulder mechanics and allow a safe return to activity.

The shoulder is a ball-and-socket joint, but unlike the hip, the socket is relatively shallow. The labrum deepens the socket and acts as a stabilizing structure. It also serves as an attachment point for ligaments and the biceps tendon. When the labrum is intact, the shoulder moves smoothly while remaining stable.

A labral tear disrupts this system. Patients often experience a catching sensation, pain with overhead movement, weakness, or a feeling that the shoulder could slip out of place. In athletes, especially those involved in throwing or contact sports, this instability can significantly limit performance.

Arthroscopic labrum repair is performed using a small camera called an arthroscope inserted through tiny incisions around the shoulder. Specialized instruments are used to clean the area, reposition the torn labrum, and secure it back to the bone using small anchors and sutures.

This technique avoids the muscle disruption associated with open surgery. As a result, patients typically experience less pain after surgery, smaller scars, and a more efficient recovery. The goal is not just to repair the tear, but to restore normal anatomy and stability.

Anterior labrum repair

An anterior labral tear occurs at the front of the shoulder. This is the most common type of labral injury and is often associated with shoulder dislocations. It is commonly referred to as a Bankart lesion.

Anterior instability typically develops after a traumatic event, such as a fall or collision, where the shoulder is forced out of position. Once the labrum is torn, the shoulder becomes more vulnerable to repeated dislocations.

During arthroscopic anterior labrum repair, Dr. Gazzaniga reattaches the torn labrum to the front of the socket. Anchors are placed into the bone, and sutures are used to secure the labrum in its proper position. This restores tension to the ligaments and stabilizes the joint.

The anterior approach is commonly used for younger, active patients, especially athletes involved in contact sports or overhead activities. It is also indicated when non-surgical treatments fail to control instability.

Posterior labrum repair

Posterior labral tears occur at the back of the shoulder and are less common. These injuries are often more subtle and may develop over time rather than from a single traumatic event. They are frequently seen in athletes who place repetitive stress on the shoulder, such as weightlifters or football players, and other collision sports.

Symptoms of posterior instability can include pain with pushing movements, weakness, or a sensation of the shoulder shifting backward. Because these symptoms can be less obvious, diagnosis may take longer.

Arthroscopic posterior labrum repair follows the same principles as anterior repair but focuses on the back of the joint. The torn labrum is repositioned and secured using anchors and sutures. The goal is to restore stability and eliminate abnormal movement within the joint. This procedure is often recommended when patients continue to have pain or instability despite physical therapy and activity modification.

Arthroscopic labrum repair is used in several clinical scenarios where shoulder stability is compromised. The most common application is recurrent shoulder instability, particularly after dislocations. When the labrum is torn, the shoulder cannot maintain proper alignment, leading to repeated episodes.

Another key application is in athletes who rely on shoulder strength and precision. Throwing athletes, swimmers, and weightlifters place significant stress on the labrum. Even small tears can affect performance and increase the risk of further injury.

Labral repair is also indicated in patients with persistent shoulder pain that does not improve with conservative care. Physical therapy can strengthen surrounding muscles, but it cannot repair a torn labrum. When symptoms continue to interfere with daily function, surgery becomes a necessary step. It is very important to note, however, that not all labrum tears need to have surgery. Sometimes it is advisable to leave it alone rather than to risk surgery.

In some cases, labral tears are combined with other injuries, such as rotator cuff damage or cartilage wear. Arthroscopy allows Dr. Gazzaniga to address multiple issues in a single procedure, improving overall outcomes.

Recovery from arthroscopic labrum repair is structured and requires commitment. Physical therapy is essential to restore full range of motion and rebuild stability. Return to normal activities depends on the severity of the injury and the demands placed on the shoulder. Most patients can expect a recovery timeline of several months. Athletes may require additional time before returning to competitive sports.

The objective is not just pain relief, but long-term stability and durability of the shoulder joint. When performed correctly and followed by appropriate rehabilitation, arthroscopic labrum repair provides reliable outcomes.

Arthroscopic labrum repair, whether anterior or posterior, is a targeted procedure designed to restore the structural integrity of the shoulder. By addressing the root cause of instability, it allows patients to regain confidence in their movement and return to their normal level of activity.

For individuals dealing with recurrent instability, persistent pain, or performance limitations, this procedure offers a clear path forward grounded in precision and proven surgical technique. Contact Dr. David Gazzaniga to schedule a consultation and learn about your shoulder conditions and all your treatment options to get you back to the life you love.

At a Glance

Dr. David Gazzaniga

  • Over 25 years of experience caring for professional athletes in the NHL, NFL, MLB, and the Olympics.
  • Division Chief of Sports Medicine at the Hoag Orthopedic Institute
  • Board-certified with a Certificate of Added Qualification (CAQ) in Sports Medicine and triple fellowship-trained
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