What Is A Labral Tear, SLAP Tear And Bankart Tear?

The labrum is a C-shaped cartilage rim located around the glenoid (socket) in the shoulder joint. It plays two crucial roles – it serves as an attachment point for the biceps tendon and the glenohumeral ligaments, and it also deepens the socket to maintain shoulder stability during movement. Shoulder injuries, such as dislocation, can cause the labrum to detach from the socket rim, resulting in shoulder instability and potential partial or complete dislocation. A labral tear, also known as a torn labrum, is a prevalent injury that is usually caused by repetitive overhead motion or a fall on an outstretched arm.

What Is A SLAP Tear?

A SLAP (Superior Labrum Anterior to Posterior) tear is a particular type of labral tear that occurs in the superior (uppermost) area of the labrum and can affect the attachment site of the biceps tendon (long head), which is typically located at the top of the shoulder joint. A Bankart tear, on the other hand, is a labral tear that creates a pocket toward the front or back of the socket, allowing the humeral (upper arm bone) head to dislocate.

SLAP and Bankart tears are typically caused by either a traumatic event, such as a fall or collision, or overuse. SLAP tears are particularly common in overhead athletes, such as tennis, volleyball, and baseball players.

What Are The Symptoms Of A Torn Labrum?

A labral tear causes a number of symptoms, including:

  • Deep shoulder pain
  • Shoulder instability
  • Decreased range of motion
  • Shoulder stiffness
  • A popping sensation
  • A clicking sensation

Individuals who have sustained SLAP and Bankart tears typically experience difficulties performing regular, everyday shoulder movements. Patients with a Bankart tear may also feel a sensation that their shoulder could dislocate or “slip” out of place.

What Are The Surgical Treatment Options For A Labral Tear?

If non-surgical methods are not effective or if the labral tear is too severe, shoulder surgery may be necessary. The type of torn labrum surgery is determined by Dr. Nawaid Ahmed based on the type and severity of tear, the condition of the biceps tendon, and any other shoulder injuries present at the time of surgery.
Some common surgical options include:

Debridement: This involves smoothing out the torn labrum, and it is typically recommended for SLAP tears that do not involve the biceps tendon.

Labrum repair: This procedure is commonly performed in cases associated with chronic shoulder instability, where the labrum is torn in the lower half of the socket. Dr. Nawaid Ahmed performs a repair of the labrum to restore stability to the joint.

Biceps tenodesis: This procedure involves removing the injured biceps tendon from the torn labrum and reinserting it into a different lower area of the shoulder on the humerus (upper arm bone). This decreases the pulling forces in the SLAP region and alleviates the painful and troublesome symptoms.

SLAP repair: This procedure is usually reserved for young, overhead athletes who want to continue being active in sports. A SLAP repair is the most common procedure for symptomatic SLAP lesions and involves reattaching the labrum to the socket using strong sutures.

Bankart repair: This is the most common shoulder surgery for patients with chronic instability. Dr. Nawaid Ahmed performs the procedure in an arthroscopic procedure, where the labral tear is repaired and the stretched anterior shoulder capsule is made to lie on top to make it smaller.