Sarah Lewis, PharmD
What is labrum repair?
Labrum repair is surgery that treats a torn labrum. Labral tears often result from acute injuries, overuse injuries, and joint dislocations. Labrum repair relieves symptoms and restores joint stability, strength, and range of motion.
The labrum is a ring of cartilage that surrounds a joint such as the hip – acetabular labrum – or shoulder – glenoid labrum. It forms a strong rim or cuff around the socket of ball and socket joints. This rim deepens the socket and provides stability to the joint. The labrum also serves as an attachment point for ligaments and tendons.
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Injuries to the labrum can cause deep joint pain, joint looseness and instability, and changes in range of motion. Popping, clicking, catching or locking of the joint can also occur.
Labrum repair is major surgery with serious risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all of your treatment choices before having labrum repair.
Why is labrum repair performed?
Your doctor may recommend labrum repair to treat a torn labrum. Your doctor may only consider labrum repair if other treatments have failed to relieve your symptoms. Ask your doctor about all of your treatment options and consider getting a second opinion.
Conditions that cause labral tears include:
Acute injuries, including falling, forceful pulling on the joint, and trauma from motor vehicle accidents
Joint dislocations due to sports-related injuries or other joint trauma
Joint impingements due to bone spurs, calcified ligaments, rotator cuff tears, or childhood joint deformity
Overuse injuries, including repetitive overhead arm movements or pivoting hip movements
Who performs labrum repair?
Orthopedic surgeons perform labrum repairs. Orthopedic surgeons are specially trained to treat problems of the bones and joints. They perform surgery and prescribe other treatments.
How is labrum repair performed?
Your labrum repair will be performed in a hospital or outpatient surgery setting. The procedure will vary depending on the type and extent of the tear and whether any tendons or ligaments are involved.
Surgical approaches to labrum repair
Your surgeon will perform your labrum repair using one of the following approaches:
Minimally invasive surgery involves inserting special instruments and an arthroscope through at least two small incisions in the joint. The arthroscope is a thin, lighted instrument with a small camera. The camera transmits pictures of the inside of your joint to a video screen. Your surgeon sees the inside of your joint on the screen while performing surgery. Your surgeon will examine and repair the labral tear as needed. Minimally invasive surgery generally involves a faster recovery and less pain than open surgery. This is because it causes less trauma to tissues. Your doctor will make small incisions instead of a larger one used in open surgery. Surgical tools are threaded around muscles and tissues instead of cutting through or displacing them as in open surgery.
Open surgery involves making a large incision in the front of your shoulder or hip. Open surgery allows your doctor to directly see and access the surgical area. Open surgery generally involves a longer recovery and more pain than minimally invasive surgery. Open surgery requires a larger incision and more cutting and displacement of muscle and other tissues than minimally invasive surgery. Despite this, open surgery may be a safer or more effective method for certain patients.
Your surgeon will advise you on which procedure is best for you and how long you need to stay in the hospital based on your diagnosis, age, medical history, general health, and possibly your personal preference. Learn about the different labrum repair procedures and ask why your surgeon will use a particular type for you.
Types of anesthesia
Your surgeon will perform your labrum repair using either general anesthesia or regional anesthesia.
General anesthesia is a combination of intravenous (IV) medications and gases that put you in a deep sleep. You are unaware of the surgery and do not feel any pain. You may also have a peripheral nerve block infusion in addition to general anesthesia. A peripheral nerve block infusion is an injection or continuous drip of a liquid anesthetic. The anesthetic flows through a tiny tube inserted near your surgical site to control pain during and after surgery.
Regional anesthesia is also known as a nerve block. It involves injecting an anesthetic around certain nerves to numb a large area of the body. You will likely have sedation with regional anesthesia to keep you relaxed and comfortable.
What to expect the day of your labrum repair
The day of your surgery, you can expect to:
Talk with a preoperative nurse. The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure you understand and sign the surgical consent form.
Remove all clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member. The surgical team will give you blankets for modesty and warmth.
Talk with the anesthesiologist or nurse anesthetist about your medical history and the type of anesthesia you will have.
A surgical team member will start an IV.
The anesthesiologist or nurse anesthetist will start your anesthesia.
A tube may be placed in your windpipe to protect and control breathing during general anesthesia. You will not feel or remember this or the surgical procedure as they happen.
The surgical team will monitor your vital signs and other critical body functions. This occurs throughout the surgery and during your recovery until you are alert, breathing effectively, and your vital signs are stabilized.
What are the risks and potential complications of labrum repair?
As with all surgeries, labrum repair involves risks and complications. Complications may become serious and life threatening in some cases. Complications can develop during surgery or recovery.
General risks of surgery
The general risks of surgery include:
Anesthesia reaction, such as an allergic reaction and breathing problems
Bleeding, which can lead to shock
Blood clot, in particular a deep vein thrombosis that develops in the leg or pelvis. A blood clot can travel to your lungs, heart or brain and cause a pulmonary embolism, heart attack, or stroke.
Infection and septicemia, which is the spread of a local infection to the blood
Potential complications of labrum repair
Complications of labrum repair are not common but include:
Blood vessel damage
Incomplete repair or postoperative failure
Instrument breakage during surgery
Joint stiffness or damage to other joint structures
Reducing your risk of complications
You can reduce the risk of certain complications by following your treatment plan and:
Following activity, dietary and lifestyle restrictions and recommendations before surgery and during recovery. This may include physical therapy and rehabilitation exercises.
Informing your doctor if you are nursing or there is any possibility that you may be pregnant
Notifying your doctor immediately of any concerns, such as inability to use the joint, bleeding, fever, increase in pain, or wound redness, swelling or drainage
Taking your medications exactly as directed
Telling all members of your care team if you have any allergies
How do I prepare for my labrum repair?
You are an important member of your own healthcare team. The steps you take before surgery can improve your comfort and outcome. You can prepare for labrum repair by:
Answering all questions about your medical history, allergies, and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.
Getting preoperative testing as directed. Testing will vary depending on your age, health, and specific procedure. Preoperative testing may include X-rays, EKG (electrocardiogram), blood tests, and other tests as needed.
Losing excess weight before surgery through a healthy diet and exercise plan.
Not eating or drinking before surgery as directed. Your surgery may be cancelled if you eat or drink too close to the start of surgery because you can choke on stomach contents during anesthesia.
Stopping smoking as soon as possible. Even quitting for just a few days can be beneficial and can help the healing process.
Taking or stopping medications exactly as directed. For labrum repair, this may include not taking aspirin, ibuprofen (Advil, Motrin), and blood thinners. Your doctor will give you instructions for taking your specific medications and supplements.
Questions to ask your doctor
Facing surgery can be stressful. It is common for patients to forget some of their questions during a doctor’s office visit. You may also think of other questions after your appointment. Contact your surgeon with concerns and questions before surgery and between appointments.
It is also a good idea to bring a list of questions to your preoperative appointments. Questions can include:
Why do I need labrum repair? Are there any other options for treating my condition?
What type of procedure do I need?
If you find a problem or another condition during surgery, will you treat it right away or will I need more surgery later?
How long will the surgery take? When can I go home?
What restrictions will I have after the surgery? When can I return to work and other activities?
Will I need physical therapy and occupational therapy? Where do I go for it?
What kind of assistance will I need at home?
What medications will I need before and after the surgery? How should I take my medications?
How will you treat my pain?
When should I follow up with you?
How should I contact you? Ask for numbers to call during and after regular hours.
What can I expect after my labrum repair?
Knowing what to expect can help make your road to recovery after labrum repair as smooth as possible.
How long will it take to recover?
You will stay in the recovery room after surgery until you are alert, breathing effectively, and your vital signs are stable. You may have a sore throat if a tube was placed in your windpipe during surgery. This is usually temporary, but tell your care team if you are uncomfortable.
You may go home the same day or stay overnight in the hospital depending on your condition.
You will likely wear a sling or use crutches for up to four weeks. Rehabilitation, including physical therapy, will help you regain joint strength, range of motion, and movement control. You will gradually return to normal activities and add new ones. Your surgeon and therapist will tell you when it is safe perform specific activities.
Recovery after surgery is a gradual process. Recovery time varies depending on the procedure, type of anesthesia, your general health, your age, and other factors. Full recovery takes about six months.
Will I feel pain?
Pain control is important for healing and a smooth recovery. There will be discomfort after your surgery. Your doctor will treat your pain so you are comfortable and can get the rest you need. Call your doctor if your pain gets worse or changes because it may be a sign of a complication.
When should I call my doctor?
It is important to keep your follow-up and physical therapy appointments after labrum repair. Contact your doctor for questions and concerns between appointments. Call your doctor right away or seek immediate medical care if you have:
Breathing problems, such as shortness of breath, difficulty breathing, labored breathing, or wheezing
Change in alertness, such as passing out, unresponsiveness, or confusion
Chest pain, chest tightness, chest pressure, or palpitations
Fever. A low-grade fever (lower than 101 degrees Fahrenheit) is common for a couple of days after surgery and not necessarily a sign of a surgical infection. However, you should follow your doctor's specific instructions about when to call for a fever.
Inability to urinate or have a bowel movement
Leg pain, redness or swelling, especially in the calf, which may indicate a blood clot
Numbness, tingling, or excessive swelling in the affected arm or leg
Pain that is not controlled by your pain medication
Unexpected drainage, pus, redness or swelling of your incision
How might labrum repair affect my everyday life?
Most people have less pain and greater joint strength after labrum repair. Labrum repair can improve joint function so you can lead a more active, normal life. It can help you to be more independent and return to many activities including sports. However, complicated repairs may limit your return to activities. Ask your surgeon what to expect from your labrum repair.
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- Arthroscopic Labral Repair Protocol – Type II, IV and Complex Tears. Brigham and Women’s Hospital: Department of Rehabilitation Services. http://www.brighamandwomens.org/Patients_Visitors/pcs/RehabilitationServices/Physical%20Therapy%20St....
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