Arthroscopic Labral Repair of the Shoulder

It was the bottom of the ninth. Tie game. Two strikes. The pitcher releases the ball and…notices pain in his shoulder. He loses velocity and accuracy in his pitches. His pain worsens during practice later, so he finally consults his doctor at OrthoKnox. After examining the pitcher’s shoulder motion, strength, and stability, the doctor orders an MRI of the pitcher’s shoulder. The scan showed that the player had been pitching with a tear in the labrum, or a SLAP tear. SLAP stands for:

S: Superior (top)

L: Labral

A: Anterior (front) to

P: Posterior (back).


A SLAP tear can be fixed at OrthoKnox, which is good news for the baseball player. Your upper arm bone, shoulder blade, and collarbone make up the ball and socket joint that is your shoulder joint. The socket that the upper arm bone fits into is the glenoid cavity, which is surrounded by fibrous tissue called the labrum. When the labrum is torn, board-certified surgeons at OrthoKnox can reattach it to its normal anatomical position and restore the anatomy of the shoulder.


Common causes of SLAP injuries

Athletes, who perform repetitive shoulder motions, such as the pitcher throwing a baseball, a swimmer swimming freestyle, or a weightlifter lifting a barbell, are at risk for developing a SLAP tear over time. In addition, acute injuries can occur when someone lands on an outstretched arm trying to catch themselves from a fall or during a car accident. SLAP injuries are also a common result of gradual wear or degeneration of the shoulder joint for people over 40 years of age.


Arthroscopic surgery

The team of physicians at OrthoKnox are able to repair SLAP injuries with minimally invasive arthroscopic surgery in about an hour. First, they make small incisions in your shoulder joint and insert a small camera, or arthroscope, with a light. The arthroscope projects the inside of your shoulder on a monitor, which allows them to guide the miniature surgical instruments during the operation.


Upon viewing the SLAP injury, the surgeon may remove the torn part of the labrum or if it is repairable, reattach it with suture anchors. If it is not repairable, the surgeon typically performs a biceps tenodesis, wherein the biceps tendon is transferred from its normal labral attachment to an attachment on the bone.  In this way, the biceps no longer pulls on the damaged labral tissue and the pain is relieved.


The surgeons at OrthoKnox also provide post-operative pain relief for their patients by using nerve blocks. Nerve block injections effectively and immediately “turn off” pain signals in a specific area. In most cases, the special blocks the OrthoKnox surgeons utilize block pain for the first 72 hours after surgery and any pain felt afterward is significantly reduced due to the disruption of the pain cycle. This is a major advancement in improving the patient’s experience with shoulder surgery.


After surgery, the patient will need to use a sling for 2 to 6 weeks depending on the severity of the injury. The patient will also need physical therapy to improve flexibility and eventually strengthen the shoulder muscles and rotator cuff. Athletes, like the baseball pitcher, can usually begin a return to throwing program approximately 4-6 months after surgery.


For more information about how OrthoRobotic Knee SurgeryKnox can diagnose and treat your SLAP injury, call (865) 251-3030, or fill out our easy-to-use online appointment request form. We look forward to hearing from you.


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