Arthroscopic Labral Repair (Bankart & SLAP)
Arthroscopic Labral Repair in Houston
The labrum is a ring of fibrocartilage that lines the rim of the shoulder socket, deepening the socket and serving as the anchor for the ligaments that stabilize the joint. Labral tears typically result from a shoulder dislocation, repetitive overhead activity, or a fall on the outstretched arm. When pain or instability persists despite non-operative care, arthroscopic labral repair is the standard surgical treatment.
Types of Labral Repair
The specific type of repair depends on which part of the labrum is torn:
- Bankart repair addresses tears of the anterior-inferior labrum, typically caused by an anterior shoulder dislocation. This is the most common labral tear pattern in young athletes and the most common reason for labral repair surgery.
- SLAP repair (Superior Labrum from Anterior to Posterior) addresses tears at the top of the labrum, where the long head of the biceps tendon attaches. SLAP repairs are most often considered in younger active patients; in older patients, biceps tenodesis (releasing and reattaching the biceps tendon at a lower position) is often a better option.
- Posterior labral repair addresses tears at the back of the socket, often seen in football linemen, weightlifters, and patients with posterior instability.
- Combined or complex repairs address tears involving more than one zone of the labrum.
Who Is a Candidate
Labral repair is most often considered for:
- Younger or athletic patients with recurrent shoulder instability or dislocations
- First-time dislocators with high recurrence risk—particularly athletes under age 25, contact athletes, and overhead athletes
- Throwing athletes with symptomatic SLAP tears that have failed non-operative care
- Patients with mechanical symptoms (catching, locking) attributable to a labral tear
- Patients with persistent pain or instability despite an appropriate course of physical therapy
In cases of significant bone loss from the socket—often from repeated dislocations—a bony stabilization procedure (such as a Latarjet procedure) may be more appropriate than soft-tissue labral repair alone.
How the Procedure Works
Arthroscopic labral repair is performed under general anesthesia, often combined with a regional nerve block.
- Positioning. The patient is typically positioned on the side (lateral decubitus) with the arm held in a position that opens up the joint for instrument access.
- Camera placement. Three to four small incisions—each under a quarter-inch—are made around the shoulder. An arthroscope is placed into the joint.
- Diagnostic evaluation. The labrum, ligaments, biceps tendon, rotator cuff, and joint cartilage are inspected to confirm the tear pattern and identify associated injuries (such as a Hill-Sachs lesion on the humerus or a bony Bankart on the glenoid).
- Tear preparation. The torn edge of the labrum is gently mobilized and the bony rim of the socket is prepared to encourage healing.
- Anchor placement. Specialized suture anchors—small implants pre-loaded with high-strength sutures—are placed into the bone along the edge of the socket. The number and location depend on the size and pattern of the tear.
- Labral repair. Sutures from the anchors are passed through the torn labrum and tied to reattach the labrum firmly to its anatomic position.
- Closure. The small incisions are closed and the arm is placed in a sling.
The procedure typically takes one to two hours, and most patients are discharged home the same day.
Recovery Timeline
Recovery after labral repair is staged to protect the repair while progressively restoring motion and strength.
Weeks 0–6: Protection Phase
- Sling is worn full-time to protect the repair
- Pendulum exercises and supervised passive motion in therapy
- No active lifting or resistance
- Ice and oral pain medications
Weeks 6–12: Motion Phase
- Sling is discontinued
- Progressive active range of motion
- Strengthening begins selectively
Months 3–6: Strengthening Phase
- Progressive strengthening of the rotator cuff and surrounding muscles
- Return to non-contact activities
Months 4–6+: Return to Sport
- Return to overhead activity and contact sport based on shoulder strength and functional testing
- Throwers require a structured return-to-throw program, typically over additional months
Outcomes
For appropriately selected patients with traumatic Bankart tears, over 90% return to their prior activity without recurrent instability after arthroscopic Bankart repair. Outcomes for SLAP repairs and complex labral patterns depend on age, activity level, and specific tear characteristics. In overhead athletes with SLAP tears, return-to-prior-level rates are more variable, which informs the decision between SLAP repair and biceps tenodesis.
Further patient education is available in the labral repair handout and the SLAP tear handout.
Houston Locations and Scheduling
Arthroscopic labral repair is performed at outpatient surgery centers in Houston affiliated with UTHealth Houston and Memorial Hermann. Office consultations are available at Memorial Villages and Texas Medical Center locations.
Appointments are scheduled through UTHealth Houston at 713-486-1700.
Frequently asked questions
What is arthroscopic labral repair?
Arthroscopic labral repair is a minimally invasive surgery to reattach a torn labrum (the rim of cartilage around the shoulder socket) using suture anchors. It is performed through three to four small incisions and is typically an outpatient procedure.
What is the difference between a Bankart repair and a SLAP repair?
Both reattach the labrum to the socket but address different tear patterns. A Bankart repair fixes a tear of the anterior-inferior labrum, typically after a shoulder dislocation. A SLAP repair fixes a tear of the upper labrum near the biceps tendon attachment, typically from overhead activity or trauma.
Who is a candidate for labral repair?
Common indications include younger or athletic patients with recurrent shoulder instability or dislocations, throwing athletes with symptomatic SLAP tears that have failed non-operative care, and patients with traumatic labral tears causing pain or mechanical symptoms.
What are the success rates of labral repair?
For appropriately selected patients with traumatic Bankart tears, over 90% return to their prior activity without recurrent instability. Outcomes for SLAP repairs and complex tear patterns depend on age, activity, and individual anatomy.
How long does the surgery take?
The procedure typically takes one to two hours, depending on the size and complexity of the tear. Most patients are discharged home the same day.
How long is the recovery after labral repair?
Most patients wear a sling for approximately six weeks, regain motion over three months, and progress through strengthening from three to six months. Return to sport typically occurs between four and six months for non-throwing athletes; throwers usually require longer.
Will I be able to return to throwing or contact sports?
Most appropriately selected patients return to their prior level of sport. Throwers typically require a structured return-to-throw program over additional months, and contact athletes typically wait at least six months to return.