Shoulder Labral Repair (Stabilization)

Overview
The labrum is a ring of cartilage that surrounds the socket of the shoulder joint, helping to keep the ball of the upper arm bone (humerus) securely in place. When the labrum is torn — often due to shoulder dislocation or repetitive instability — the shoulder can feel loose or unstable, and patients may experience pain, weakness, and a sensation that the shoulder might "slip out."
Shoulder labral repair, also called shoulder stabilization surgery, is designed to restore the normal anatomy of the shoulder, reduce the risk of future dislocations, and allow patients to return to their activities safely.

Factors Influencing Outcomes
Several factors can affect the success of labral repair and shoulder stabilization:

• Severity of the tear: Larger or more complex tears may require more extensive repair.

• Number of dislocations: Repeated dislocations can stretch or damage the ligaments and surrounding structures, which may impact healing.

• Patient age and activity level: Younger and more active patients, especially contact athletes, have a higher risk of recurrent instability but also benefit greatly from surgical stabilization.

• Bone loss: Significant bone loss on either the socket (glenoid) or ball (humerus) side may require additional procedures.

The Shift Toward Early Stabilization
For patients at higher risk of recurrent dislocation — such as young athletes or individuals with significant soft tissue injury — there has been a shift toward earlier surgical stabilization rather than repeated nonoperative treatment.
Early labral repair can restore shoulder stability, protect the cartilage from further damage, and help patients safely return to sports and active lifestyles. For lower-risk patients, nonoperative management with physical therapy is often the first step, reserving surgery for persistent instability.

The Procedure

Labral repair is typically performed as an outpatient arthroscopic procedure, using small incisions and a tiny camera to access the shoulder joint. Specialized instruments are used to:

• Visualize the tear and surrounding structures.

• Prepare the torn edges of the labrum and bone to promote healing.

• Secure the labrum back to the bone using small anchors and sutures.

The goal is to restore the normal anatomy of the shoulder and re-tighten the capsule to prevent further instability.

Addressing Associated Issues
During labral repair surgery, your surgeon may also address additional factors that contribute to instability:

• Capsular tightening: If the joint capsule is loose, it may be tightened to improve stability.

• Bone loss evaluation: If there is significant bone loss from the socket (glenoid), additional procedures may be recommended to restore stability. Two common options include:

  • Latarjet procedure: This involves transferring a piece of bone from the shoulder blade (coracoid) to the front of the socket to restore bone loss and improve stability.

  • Distal tibial allograft reconstruction: This uses donor bone from the lower leg to reconstruct the socket and restore normal anatomy.

• Hill-Sachs lesion management (Remplissage): In some cases, shoulder dislocation causes a dent or divot in the back of the ball of the shoulder (called a Hill-Sachs lesion). If this defect is engaging and contributes to instability, a procedure called remplissage may be performed. In this technique, the defect is filled using nearby soft tissue to prevent the ball from catching on the edge of the socket and redislocating.

Your surgeon will carefully assess these factors using imaging and during surgery to determine if any of these additional procedures are necessary to achieve a stable, long-lasting repair.

Recovery Process

• Initial Phase (0–6 Weeks): The shoulder is immobilized in a sling to protect the repair. Physical therapy focuses on maintaining motion in nearby joints and beginning gentle passive shoulder motion.

• Intermediate Phase (6–12 Weeks): Therapy progresses to active range of motion and light strengthening exercises.

• Advanced Phase (3–6 Months): Therapy focuses on advanced strengthening and dynamic shoulder stability exercises.

• Full Recovery: Most patients return to sports and full activities by 4–6 months, depending on their progress in rehabilitation.

Risks and Considerations

• Risk of recurrent instability, though much lower after surgical repair.

• Risk of shoulder stiffness if post-operative rehabilitation is not followed.

• Possible nerve irritation or damage (rare).

• Risk of needing additional procedures if bone loss or re-injury occurs.

• Infection or bleeding (rare).

Conclusion
Shoulder labral repair is a safe and effective procedure to restore stability to the shoulder and reduce the risk of future dislocations. If you are experiencing shoulder instability, contact our office for a comprehensive evaluation and personalized treatment plan.

Frequently Asked Questions

Will I need to wear a sling after surgery?
Yes. Most patients wear a sling for 4–6 weeks to protect the repair while the tissue heals.

Can physical therapy alone treat a labral tear?
For some patients with mild instability, physical therapy can help strengthen the shoulder and avoid surgery. However, for patients with recurrent dislocations or significant tears, surgical repair is often recommended.

When can I return to sports?
Most patients return to full sports activity between 4–6 months after surgery, depending on their progress in therapy and the demands of their sport.

Will this procedure prevent future dislocations?
Surgical repair significantly reduces the risk of future dislocations, especially in active and young patients. However, no procedure can guarantee zero risk.

What if there is bone loss in my shoulder?
If there is significant bone loss, your surgeon may recommend additional procedures to restore stability, such as bone grafting or a Latarjet procedure.