From the Research
The treatment for an anterior inferior labrum tear typically begins with conservative management, but arthroscopic labral repair is a highly effective surgical approach, as evidenced by a study showing highly satisfactory clinical outcomes at 10 years, with complication and redislocation rates similar to those reported at 2 years 1.
Treatment Approach
The decision between conservative and surgical management depends on the patient's age, activity level, tear severity, and presence of instability.
- Conservative management includes rest, physical therapy, and anti-inflammatory medications such as ibuprofen (400-800mg three times daily) or naproxen (500mg twice daily) for 1-2 weeks.
- Physical therapy focuses on strengthening the rotator cuff and scapular stabilizers while improving range of motion, usually requiring 6-12 weeks of consistent sessions.
- If conservative treatment fails after 3-6 months or if the tear is severe (especially in young, active individuals or athletes), surgical intervention may be necessary.
Surgical Intervention
Arthroscopic labral repair is the most common surgical approach, where the torn labrum is reattached to the glenoid rim using suture anchors.
- Post-surgical rehabilitation is crucial and typically involves wearing a sling for 2-4 weeks, followed by progressive physical therapy for 4-6 months.
- A study published in The American journal of sports medicine found that arthroscopic repairs of 270° labral tears involving the anterior, inferior, and posterior labrum have highly satisfactory clinical outcomes at 10 years, with a mean postoperative Western Ontario Shoulder Instability Index (WOSI) score of 256.3 ± 220.6 1.
Recovery and Outcomes
Complete recovery, regardless of treatment approach, typically takes 6-12 months.
- The study by 1 reported a failure rate of 14.2%, with two patients requiring revision surgery.
- The outcomes of the study suggest that repairs of extensile labral tears are effective in restoring and maintaining mechanical stability of the glenohumeral joint in the long term.