Sports MedicineShoulderSurgery Center

Arthroscopic Labral Repair

A tear-pattern-specific operation for symptomatic anterior, posterior, superior, or circumferential labral injuries that have not improved with appropriate nonsurgical care or that cause clinically important instability.

Duration: Approximately 60–120 minutes, depending on tear extentAnesthesia: General anesthesia with regional nerve block

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What is Arthroscopic Labral Repair?

Arthroscopic labral repair is outpatient shoulder surgery that uses a camera, small instruments, and suture anchors to reattach torn labral tissue to the socket. The specific repair depends on whether the tear is anterior, posterior, superior, or circumferential and whether instability, bone loss, or biceps disease is also present.

Why this approach — at MOS

“Labral repair” is not a single operation. The anchor position, capsular tension, treatment of the biceps attachment, and need to address bone loss must match the tear pattern and the patient’s sport. MOS shoulder surgeons evaluate the full shoulder rather than treating an MRI finding in isolation.

Bankart repair is the specific anterior-inferior version used for selected anterior-instability cases. SLAP repair addresses the superior labrum and biceps anchor in carefully selected patients. Posterior and circumferential tears require different anchor placement and rehabilitation precautions.

Who is a candidate?

Candidates typically have pain, mechanical symptoms, or instability that matches the examination and imaging, plus a repairable labral tear. Surgery is commonly considered after an appropriate rehabilitation program has not restored function, or earlier when recurrent instability or associated injury makes nonsurgical care less reliable.

An MRI finding alone is not an indication for surgery. Age, sport, tear location, tissue quality, glenoid and humeral bone loss, prior dislocations, capsular laxity, and biceps pathology all influence whether repair, biceps tenodesis, bone augmentation, continued rehabilitation, or another treatment is most appropriate.

The procedure

The procedure is performed through several small portals with the patient under general anesthesia, commonly with an interscalene nerve block for postoperative pain control. The surgeon examines the cartilage, labrum, biceps anchor, rotator cuff, capsule, and bone surfaces before confirming the repair plan.

Unstable labral tissue is mobilized and the glenoid rim is prepared to support healing. Small suture anchors are placed in positions determined by the tear: anterior-inferior for a Bankart lesion, posterior for a posterior tear, superior for a selected SLAP tear, or across multiple regions for a 270-degree or circumferential injury. The sutures restore the labral bumper and appropriate capsular tension without over-constraining the shoulder.

Associated procedures may include capsular plication, biceps tenodesis, remplissage, or treatment of cartilage and rotator-cuff pathology. Clinically important bone loss may require a different stabilization strategy rather than isolated arthroscopic soft-tissue repair.

Recovery timeline

Weeks 0–4 or 6 — Protect the repair

The arm is protected in a sling. Hand, wrist, elbow, and surgeon-approved gentle shoulder motion begin while positions that stress the repaired region are restricted.

Weeks 4–8 — Restore controlled motion

Physical therapy progresses passive and active-assisted motion according to the tear location and tissue quality. Sling use is discontinued when the surgeon determines the repair is ready.

Weeks 8–16 — Rebuild strength

Active motion, rotator-cuff strengthening, scapular control, and progressive functional loading advance after healing and motion milestones are met.

Months 4–6 — Sport-specific progression

Running, noncontact training, and sport-specific drills progress based on strength, pain-free motion, stability, and the demands of the repair.

Months 6–12 — Return to higher-risk activity

Contact, collision, and competitive overhead sports require criteria-based clearance. Throwing athletes and complex or multi-region repairs may need the longer end of the range.

Recovery is determined by the location and extent of the repair, associated procedures, sport, and individual healing. A posterior repair has different early motion precautions than an anterior repair, and a SLAP repair protects resisted biceps loading. The operative report and surgeon-specific protocol therefore guide therapy.

Calendar estimates are planning ranges, not automatic clearance dates. Return requires adequate healing, pain-free functional motion, strength, stability, and successful sport- or work-specific testing.

Frequently Asked Questions

Is arthroscopic labral repair the same as Bankart repair?

Bankart repair is one type of arthroscopic labral repair. It specifically reattaches the anterior-inferior labrum for selected cases of anterior shoulder instability. Arthroscopic labral repair is the broader category and also includes posterior, SLAP, and multi-region repairs.

Does every shoulder labral tear need surgery?

No. Many degenerative, incidental, or lower-risk tears can be managed with rehabilitation, activity modification, and symptom control. Surgery is considered when symptoms and examination findings match a repairable tear and meaningful limitations persist, or when instability and anatomy make recurrence a concern.

How is the exact type of repair chosen?

The surgeon combines the history, physical examination, MRI or MR arthrogram, and assessment of bone loss. Arthroscopy confirms tear location and tissue quality. The final plan may involve anterior, posterior, superior, or multi-region repair and sometimes an additional procedure.

How long will I wear a sling after labral repair?

Many patients use a sling for approximately four to six weeks, but the exact period varies with tear location, repair extent, associated procedures, and surgeon protocol. Early elbow, wrist, and hand motion is generally encouraged while the shoulder repair is protected.

When can I return to sports?

Lower-risk training often begins several months after surgery. Contact, collision, and overhead sports commonly require six months or longer, and competitive throwing may take nine to twelve months. Clearance is based on healing, motion, strength, stability, and sport-specific testing.

What if my shoulder also has bone loss?

Bone loss can make isolated soft-tissue repair less reliable. Your surgeon evaluates the glenoid and Hill-Sachs lesion together with age, sport, and prior instability. Remplissage, Latarjet, or another stabilization strategy may be recommended instead of or in addition to labral repair.