This is a keyhole operation performed under general anaesthesia and regional nerve block. Tiny (<1cm) incisions allow introduction of the arthroscope, instruments and implants.
A tear in the superior labrum is often called a SLAP tear. This term stands for 'Superior Labrum Anterior and Posterior (to Biceps tendon)'. The injury tends to occur from a sudden traction injury to your shoulder; a direct blow to your shoulder (landing heavily on your side); or after repeated twisting motions from overhead sports (tennis, throwing etc).
The superior labrum and the origin of the long head of your biceps tendon are intimately related, so the symptoms of both can overlap, and sometimes a tear of the superior labrum is best treated by disconnecting the long head of the biceps tendon from the glenoid socket.
Your pattern of superior labral injury is assessed to decide which treatment option is best for you:
The torn superior labrum is mobilised from scar tissue. The exposed upper glenoid bone is prepared to optimise healing using a rasp or a burr and your superior labrum is reattached to bone using suture anchors (as shown below).
Arthroscopic image of a repaired SLAP tear. Two anchors have been used to fix the tear and stabilise the biceps tendon (just out of shot anterior to the right-hand anchor). Mr Granville-Chapman uses knotless suture anchors to minimise the risk of abrasion of the suture material against the cartilage and rotator cuff. An illustration of the same technique is shown below.
Superior labrum is repaired to the glenoid using suture anchors
You will usually go home on the same day as your operation. Please take your painkillers regularly for the first few days and begin them before your nerve block wears off.
You will need to wear a sling six weeks. Your physiotherapist will guide you through your rehabilitation. After 6 weeks you will progress to active shoulder motion and you will begin to strengthen from 10 weeks. All restrictions will be removed by 6 months.
You can take down bulky padded dressings on day 2 after surgery, but keep your wound dry and covered with your waterproof dressings for 12 days. You can shower from 4 days with waterproof dressings on.
Patients vary in their symptoms after surgery, but in general you can expect to return to:
Office work after two weeks or so (in a sling)
Light physical work after twelve weeks
Heavier labour may take 5-6 months
Contact or overhead sport usually takes six months
Driving is allowed once you are confident and competent to control a car both for routine and emergency manoeuvres. It will probably take about eight weeks for you to be ready.
By six months, 85% of patients will feel their shoulder is better. You may notice some stiffness in your shoulder, but this is usually improves over the first year from your operation.
You will be seen at two weeks after your operation. Depending on your progress, your on-going follow up will vary, but many patients can be discharged between six months and twelve months after surgery
Keyhole Shoulder surgery is generally very safe, but specific risks of Superior Labral Repair surgery
• Persistent stiffness (5%), rarely needs surgery, but occasionally requires arthroscopic capsular release
• Failure of healing/re-tear (<15%). This may require further surgery, normally a biceps tenodesis
• Occasionally (10%) patients notice on-going pain in their shoulder and a cause for this is not always found
Mr Granville-Chapman was very polite and his examination and explanation of my symptoms and expected treatment was thorough
I found Mr Granville-Chapman to be very knowledgeable and professional. He put me very much at ease and explained all the options that I have thoroughly. He also told me to look for further information on the condition and procedures that I needed on his website, which gave lots of information and detail. It was also easy to understand for those without a medical background. I would highly recommend his services to anyone that has shoulder problems and requires a solution.
I attended for a repair of my right bicep tendon. After a thorough examination, Mr Granville-Chapman arranged an operation to be undertaken within 2 days which was extremely quick; he explained his reasoning which was both thorough and reassuring, explaining both the options of undergoing surgery and deciding to undertake conservative management.On the day of the surgery Mr Granville-Chapman was again very reassuring as although this is minor surgery I was still somewhat apprehensive. He came to fully explain the procedure and afterI woke up was quick to check on how I was doing.Overall I am very happy with the careMr Granville-Chapman
I have been very pleased with my treatment so far. Mr Granville-Chapman combines brisk efficiency with a pleasant, sympathetic manner. My operation, however, is still to come ...
From the initial consultation, through surgery on a fractured wrist, and now post-operative follow up, it has been a very positive and reassuring experience with Mr Granville-Chapman. I would have no hesitation in recommending him to someone else.
A first class clinician. A skilled surgeon with an excellent bedside manner.
A very pleasant Consultant who knows exactly how to make pain go away.
Mr Granville - Chapman has an excellent bedside manner. He engaged with my 12 year old son at an appropriate level and took the time to ensure that he understood the procedure and answer all his questions. He is thoroughly professional and I would not hesitate to recommend him.
I have been very pleased with the attention I have received. Mr. Granville-Chapman has reassured me that my symptoms are normal. It is very easy to make appointments that suit me.
Mr Granville chapman I found be caring informative and professional I would recommend him to all if you have a problem don't hesitate to contact him you won't be disappointed.
I recently broke my right clavicle in a mountain bike accident and it was repaired by Mr Granville-Chapman by adding a plate on top of the bone. Having just finished the last post-op consultation, I can confirm that I have been very happy with the process all along. In particular, Jeremy took time to explain in detail why a plate was needed, what the procedure would entail, and also was very patient answering my questions comprehensively beforehand and after during the recovery phase. Would certainly trust this competent surgeon to fix any future fractures I might sustain.
Mr Granville-Chapman has looked after my 15 year old son brilliantly, explaining the surgery, recovery and best way forward, and Kate has been very supportive helping with logistics etc, thank you so much.
So far my experience with Mr Jeremy Granville-Chapman has been personal and informative with regard to the operation I will be having. I feel confident that my operation will be a success and for this reason I am very happy to have Mr Jeremy Granville-Chapman as my consultant.
Very knowledgeable and helpful. Takes the time to make sure you're getting the treatment you need.
Mr Jeremy Granville -Chapman is not only a highly skilled consultant but is able to put you straight away at ease .My appointments were arranged very swiftly which was great, when you are experiencing severe pain. I am very happy with my treatment so far . many thanks to everyone who was involved in my treatment.
Polite, helpful, professional. Makes an effort to ensure full understanding of issues and procedures to be done. Highly satisfied
Very pleasant. Clear, careful explanations & options/possibilities. I feel well informed, and happy that my concerns are being well addressed, with a plan of review of the symptoms.
Excellent advise with everything explained clearly and a successful treatment which has benefited be greatly.
BMI The Princess Margaret Hospital
Osborne Rd, Windsor SL4 3SJ
Spire Thames Valley hospital
Wexham Street, Wexham, Buckinghamshire, SL3 6NH
Wexham Park Hospital, Slough, Berkshire, SL2 4HL
Unit 6, Queen's Square, Ascot Business Park, Lyndhurst Road, Ascot, SL5 9FE