Arthroscopic Reconstruction of Shoulder Joint Dislocation :: SLAP Tears

Arthroscopic Reconstruction of Shoulder Joint Dislocation

Shoulder dislocation occurs when the end of the upper arm bone (humerus), the ball portion, partially or completely dislocates from the glenoid, the socket portion of the shoulder. A partial dislocation is called subluxation and occurs when the end of the humerus is partially out of the socket. Shoulder joint may dislocate in the forward, backward or downward direction, but most commonly it occurs in forward direction (anterior instability).

Shoulder dislocation may cause pain and shoulder joint instability. Other symptoms such as swelling, numbness and bruising may occur. At times, it may cause tear in the ligaments or tendons of the shoulder and nerve damage. Your doctor will examine your shoulder and may order an X-ray to confirm the diagnosis.

The condition is treated by a process called closed reduction which involves placing the ball of the upper arm back into the socket. Following this, the shoulder will be immobilized using a sling for several weeks. Ice may be applied over the area for 3-4 times a day. Rehabilitation exercises may be started to restore range of motion, once the pain and swelling decrease.

SLAP Tears

SLAP Lesions

The shoulder joint is a ball and socket joint. A 'ball' at the top of the upper arm bone (the humerus) fits neatly into a 'socket', called the glenoid, which is part of the shoulder blade (scapula). The term SLAP (superior –labrum anterior-posterior) lesion refers to an injury of the superior labrum of the shoulder. The labrum is a ring of fibrous cartilage surrounding the glenoid for stabilization of the shoulder joint. The biceps tendon attaches inside the shoulder joint at the superior labrum of the shoulder joint. The biceps tendon is a long cord-like structure which attaches the biceps muscle to the shoulder and helps to stabilize the joint.

The most common causes include falling on an outstretched arm, repetitive overhead actions such as throwing, and lifting a heavy object. Overhead and contact sports may put you at a greater risk of developing SLAP lesions.

The most common symptom is pain at the top of the shoulder joint. In addition, catching sensation and pain most often with activities such as throwing may also occur.

Diagnosis is made based on the symptoms and physical examination. A regular MRI scan may not show up a SLAP tear and therefore an MRI with a contrast dye injected into the shoulder, is ordered. The contrast dye helps to highlight SLAP tears.

Your doctor may recommend anti- inflammatory medications to control pain. In athletes who want to continue their sports, arthroscopic surgery of the shoulder may be recommended. Depending on the severity of the lesion, SLAP lesions may simply require debridement or some may need to be repaired.  A SLAP repair can be done using arthroscopic techniques that require only two or three small incisions.

Regular exercises that make the shoulder muscles strong should be done. Adequate warm-up exercises before activities and avoiding high contact sports can help prevent injuries that cause instability.