What is Labrum in the shoulder?

The shoulder joint is covered completely by a lax tissue structure called a capsule. This capsule is a peculiar structure & is loose enough to allow the shoulder wide range of movement but is just tight enough to prevent it from dislocating. This capsule gets thickened in certain locations & one such structure is the labrum which encircles the glenoid bone to increase its surface area & also coverts the flat glenoid to a concave structure has preventing the shoulder from dislocation in extreme range of motion especially when it is taken up & above

What happens in shoulder dislocation?

Most common type of shoulder dislocation is Anteroinferior ie forwards & downwards when the shoulder dislocates the capsule & labrum are torn off the front margin of the glenoid & this labrum doesn’t heal back in its position adding to persistent instability when ever the shoulder is taken upwards & outwards it will dislocate in the front

What is recurrent shoulder dislocation & its symptoms?

After the 1st dislocation episode especially in people of younger age group the should keeps on dislocating whenever it is taken upwards & outwards because of the reasons explain above this frequent dislocation of the shoulder is called as recurrent dislocation of the shoulder

With each subsequent dislocation there is accompanying erosion of the bone which leads to further instability & more frequent episodes complicating the problem further. A person suffering from recurrent dislocation has fear of taking he arm upwards & outwards, pain while lifting the arm & difficulty in combing the hair wearing clothes etc. It is important to note that a labrum tear doesn’t occur unless there is an episode of dislocation

What is the treatment of labrum tear?

Once the shoulder starts dislocating repeatedly it means the labrum has not healed in the correct location & this needs surgical repair One needs to undergo an MRI scan to see the status of the labral tear & also a CT scan to evaluate the amount of bone erosion already present

Depending upon the percentage of bone erosion the decision is made if the bone loss is less than 20% then one can undergo arthroscopic Bankart’s repair where in the torn labrum is repaired back to the glenoid bone using special implants known as suture anchors. If the bone loss is more than 20% chances of failure of arthroscopic repair are high so in these cases a Latarjet procedure is done where the glenoid bone augmented with a coracoid bone graft with attached muscle tendon to it

So it is very important for person with dislocation of the shoulder to get assessed early by a shoulder surgeon to keep the damage to the tissues to a minimum