labral tear repair with posterior inferior capsular release

This thrower was a little older - mid 30s - and had been throwing with pain for a long time, essentially ignoring the problem. The ragged appearance (fibrillation) of the tissues shows how damaging throwing can be to a shoulder.

	This arthroscopic view shows the torn labrum. It is the white tissue being held by the metal probe. This is a classic SLAP tear (superior labral anterior to posterior). The ball of the ball-and-socket joint is the white on the upper half of the photo.
	Here we see the frayed and torn labrum near the posterior inferior capsule, where the thrower's shoulder is typically tight.
	This is another look at the torn labrum. The metal device is a motorized shaver that allows the surgeon to remove this torn / frayed tissue and smooth it out.
	After this shaving, the remaining labrum is quite smooth.
	Now, the posterior inferior capsule is cut to release that tight ligament that throwers have. This reveals the muscle outside the capsule, which is the red. When the surgeon sees the red muscle, he knows the capsular release is complete.
	Here, the labrum has been repaired with stitches, to reattach it directly to the bone. This completes the repair of this thrower's shoulder problem.

Arthrex Push-Lock Suture Anchor Animation - an animation done by Arthrex that will clarify the details of placing the sutures in the above surgical procedure. If you watch this animation closely, please note that we at SafeThrow use a technique that is improved over the one depicted in that animation. The technique in the animation shows each suture passed one time around the labrum. The improved technique, demonstrated in the above sequence of photographs, loops the suture and thus passes each suture around the labrum TWICE. This gives greater contact area of the labrum to the bone under the suture, and increases the strength each anchor provides to the repair.