Labral Tears

Advances in medical technology are enabling doctors to identify and treat glenoid labrum tears and injuries that went unnoticed 20 years ago. For example, physicians can now use miniaturized television cameras to see inside a joint. With this tool, they have been able to identify and treat a shoulder injury called a glenoid labrum tear.

The shoulder joint has three bones: the shoulder blade (scapula), the collarbone (clavicle), and the upper arm bone (humerus). The head of the upper arm bone (humeral head) rests in a shallow socket in the shoulder blade called the glenoid. The head of the upper arm bone is usually much larger than the socket, and a soft fibrous tissue rim called the labrum surrounds the socket to help stabilize the joint. The rim deepens the socket by up to 50% so that the head of the upper arm bone fits better. In addition, it serves as an attachment site for several ligaments.

Cause

Injuries to the tissue rim surrounding the shoulder socket can occur from acute trauma or repetitive shoulder motion.

Examples of traumatic injury include:

  • Falling on an outstretched arm
  • A direct blow to the shoulder
  • A sudden pull, such as when trying to lift a heavy object
  • A violent overhead reach, such as when trying to stop a fall or slide
  • Throwing athletes or weightlifters can experience glenoid labrum tears as a result of repetitive shoulder motion

Shoulder Conditions

  • Bankart Lesion
  • Biceps Tendon Rupture
  • Broken Collarbone
  • Burners & Stinger
  • Bursitis
  • Chronic Shoulder Instability
  • Fracture of the Shoulder Blade
  • Frozen Shoulder
  • Labral Tear
  • Rotator Cuff Tear
  • Shoulder Arthritis
  • Shoulder Dislocation
  • Shoulder Impingement Syndrome
  • Shoulder Pain
  • Shoulder Separation
  • Superior Labrum Anterior to Posterior (SLAP)
  • Throwing Injuries[/li_item|

Shoulder Treatments

  • Acromioplasty
  • Arthroscopic Bankart Repair
  • Biceps Tendon Rupture Surgery
  • Biceps Tenodesis
  • Broken Collarbone Surgery
  • Bursitis/Shoulder Impingement Surgery
  • Closed Reduction Shoulder Surgery
  • Labrum Surgery
  • Instability Shoulder Surgery
  • Reverse Shoulder Replacement Surgery
  • Revision Shoulder Replacement Surgery
  • Rotator Cuff Repair
  • Shoulder Arthritis Surgery
  • Shoulder Arthroscopy Surgery
  • Shoulder Impingement Syndrome Treatment
  • Shoulder Separation Surgery
  • Total Shoulder Replacement Surgery
  • Throwing Injury Surgeries

Conservative Treatments

The Orthopedic physicians at Peninsula Bone & Joint Clinic provide conservative treatment options for Shoulder conditions and injuries.

Symptoms

The symptoms of a tear in the shoulder socket rim are very similar to those of other shoulder injuries.

Symptoms include:

  • Pain, usually with overhead activities
  • Catching, locking, popping, or grinding
  • Occasional night pain or pain with daily activities
  • A sense of instability in the shoulder
  • Decreased range of motion
  • Loss of strength

Diagnosis

Physical Examination & Patient History

During your first visit, your doctor will talk to you about your symptoms and medical history. During the physical examination, your doctor will check all the structures of your injury, and compare them to your non-injured anatomy.  Most injuries can be diagnosed with a thorough physical examination.

Imaging Tests

Imaging Tests Other tests which may help your doctor confirm your diagnosis include:

X-rays. Although they will not show any injury, x-rays can show whether the injury is associated with a broken bone.

Magnetic resonance imaging (MRI) scan. If your injury requires an MRI, this study is utilized to create a better image of soft tissues injuries. However, an MRI may not be required for your particular injury circumstance and will be ordered based on a thorough examination by your Peninsula Bone & Joint Clinic Orthopedic physician.

Treatment Options

Non-Surgical

Until the final diagnosis is made, your physician may prescribe anti-inflammatory medication and rest to relieve symptoms. Rehabilitation exercises to strengthen the rotator cuff muscles may also be recommended. If these conservative measures are insufficient, your physician may recommend arthroscopic surgery.

Surgical

During arthroscopic surgery, your PB & JC surgeon will examine the rim and the biceps tendon. If the injury is confined to the rim itself, without involving the tendon, the shoulder is still stable. The surgeon will remove the torn flap and correct any other associated problems. If the tear extends into the biceps tendon or if the tendon is detached, the shoulder is unstable. The surgeon will need to repair and reattach the tendon using absorbable tacks, wires, or sutures.

Tears below the middle of the socket are also associated with shoulder instability. The surgeon will reattach the ligament and tighten the shoulder socket by folding over and “pleating” the tissue

Shoulder Treatment Highlights

Reverse Total Shoulder Replacement by Dr. Todd Kim

Dr. Todd Kim provides innovative shoulder replacement options to patients with shoulder joint compromise.

A standard total shoulder replacement is designed to work only if the rotator cuff muscles and tendons are in tact and working properly. If the rotator cuff muscles are not working properly, a Reverse Total Shoulder replacement is needed.

In a Reverse Total Shoulder replacement, the glenoid component is shaped like a ball and anchored to the scapula by screws. The humeral component then becomes the new socket of the joint and attaches to the upper end of the humerus.

The joint configuration of a Reverse Total shoulder replacement allows the patient to now us the deltoid muscle instead of the torn rotator cuff to lift the arm.

Total Shoulder Replacement by Dr. Todd Kim

Dr. Todd Kim provides innovative shoulder replacement options to patients with shoulder joint compromise.

Total shoulder replacement arthroplasty is a well-established surgery for restoring comfort and function to the arthritic shoulder.

In this procedure the arthritic ball is replaced by a smooth metal ball fixed to the arm bone (humerus) by a stem that fits within it.

The arthritic socket (glenoid) is resurfaced with high-density polyethylene prosthesis. Among the different surgical options this procedure appears to provide the most rapid and complete improvement in comfort and function for shoulders with arthritis.

Success requires technical excellence of the surgery and a commitment to the exercise program until the desired range of motion can be achieved comfortably.

Peninsula Bone & Joint Clinic

The Orthopaedic physicians at Peninsula Bone & Joint Clinic provide comprehensive services to all members of the family.
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