Surgical repair of the shoulder’s labrum is recommended when:

Non-surgical interventions fail to improve shoulder function or reduce pain for over 3 to 6 months
Superior labral anterior to posterior (SLAP) injuries involve a complete detachment of the labrum from the shoulder’s socket (glenoid cavity)

Athletes or manual laborers regularly engaged in activities involving overhead arm movements are more likely to require surgical treatment than non-athletes.

Type II SLAP tears, involving the detachment of the labrum from the shoulder socket, are the most common type of SLAP lesion, and most SLAP surgeries involve the treatment of this type of labrum tear.^,

In This Article:

Types of Surgeries for Shoulder Labrum Tears

Illustration showing anatomy of shoulder joint anthroscope and another inset showing trimmed labrium.

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SLAP injuries are treated with minimally invasive arthroscopy called labrum debridement.

The degree and type of labrum injury dictate the type of surgery needed for SLAP lesions.

If there are associated rotator cuff lesions, treating those lesions is sometimes sufficient to resolve the symptoms of shoulder pain and stiffness.

Debridement

SLAP injuries involving fraying of the labrum without detachment, also called type I injury, are treated with minimally invasive surgery (arthroscopy), known as labrum debridement.

In this surgery, the frayed labrum is smoothened to prevent further tearing.

SLAP repair

Type II and type IV SLAP tears are commonly treated using SLAP repair. Type II SLAP tears involve the detachment of the labrum without a tear in the labrum, while type IV tears involve a detachment of the labrum along with a tear in the biceps tendon.

A SLAP repair surgery is a minimally invasive procedure where the labrum is reattached to the shoulder joint socket (glenoid cavity) using staples or sutures.

SLAP repair is the preferred surgery for acute labrum injuries and younger patients under the age of 35 years.

Biceps tenodesis

Illustration showing torn tendon, incision site, and tendon trimmed.

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Surgical repair of the labrum involves reattaching the cartilage to the shoulder joint socket.

Similar to SLAP repair, biceps tenodesis is indicated when the labrum and biceps tendon tear and/or detach from the shoulder socket (type II and type IV injuries). A failed SLAP repair surgery is also treated with biceps tenodesis.

In biceps tenodesis, the biceps tendon is detached from the labrum cartilage and surgically attached to the upper arm bone (humerus) using a tendon anchor. Both open surgery and minimally invasive techniques are used for biceps tenodesis.

Potential Side Effects and Complications of SLAP Surgery

As with any surgical procedure, there is a potential risk of adverse events and complications associated with SLAP tear surgery. Common side effects include:

Shoulder pain
Soreness
Stiffness
Instability

These side effects usually improve over time with physical therapy and exercise.

Severe shoulder stiffness is the most prevalent complication of SLAP surgery and is observed in less than 5% of individuals treated with either SLAP repair or biceps tenodesis.

In rare cases, severe pain, damage to blood vessels and nerves, and/or infection may occur.

Success Rates of SLAP Tear Surgery

Surgical repair of the labrum, commonly indicated in type II SLAP tears, has success rates ranging from 71% to 97%.^,

Around 2% to 10% of individuals who undergo SLAP tear surgery experience post-surgical pain and stiffness, necessitating a revision surgery.

An increased risk of requiring revision surgery exists in individuals with obesity, female gender, age over 40, and concurrent biceps tendon tears along with the SLAP injury.

Recovery after SLAP Tear Surgery

While surgical procedures for labrum tears vary—depending on the type and severity of the tear—there are a few broad post-surgical management guidelines to keep in mind:

Recovery Timeline after SLAP Surgery	Recovery Guidelines
2-4 weeks after surgery	The affected arm is immobilized in a sling Icing and non-steroidal anti-inflammatory drugs (NSAIDs) are recommended to reduce pain and inflammation
3-6 weeks after surgery	Gentle shoulder exercises are prescribed to reduce stiffness and improve range of motion Gradual incorporation of strengthening exercises for the rotator cuff, biceps, and shoulder blade muscles
6-12 weeks after surgery	Activity modifications involving limiting or avoiding overhead and repetitive arm movements and lifting heavy objects
3 months after surgery	Gradual initiation of sports-related exercises or overhead occupational activities for athletes and laborers, respectively
4-6 months after surgery	Overhead activities, such as throwing, are gradually initiated
8-9 months after surgery	Full return to sports and recreational activities

It is advisable to follow the instructions provided by the orthopedic surgeon and physical therapist during the post-surgery recovery phase. Returning prematurely to activities that strain the surgically repaired shoulder, particularly overhead movements, increases the risk of surgical failure.

Patients should discuss the potential benefits, risks, and surgical alternatives with the surgeon before opting for surgery.

Dr. Terry Gemas is an orthopedic surgeon and the founder of Lakewood Orthopaedics and Sports Medicine in Dallas, TX. He specializes in sports medicine and has been in practice for more than 15 years. Dr. Gemas has treated professional athletes and currently serves as the head team physician for several Dallas-Forth Worth area high school, college, and club teams.