Stemcelldoc's Weblog

February 28, 2009

Labral Tears in the Shoulder

The labrum is a cartilaginous cup which circles the shallow shoulder socket (the glenoid) to make the socket deeper.  The labrum supports and stabilizes the shoulder joint.

Shoulder Labrum

Shoulder Labrum

Injury to the labrum typically occurs from repetitive trauma in overhead throwers, such as in baseball.  It can also occur from a traction injury to the arm, such as lifting a heavy object off the ground or getting your arm jerked.

Typical symptoms include pain in the front of the shoulder or deep inside the joint.

Treatment options initially  include physical therapy which is designed to restore range of motion and strength to the shoulder.  Often times shoulder arthroscopy is recommended where the damaged labrum is identified and then repaired using suture anchors to sew the labrum back in place.

Surgical Repair of Labrum

Surgical Repair of Labrum

At the Centeno-Schultz Clinic we have developed x-ray guided techniques to safely inject the labrum.  Once a small needle is appropriately placed, we inject a very small amount of contrast(dye) to confirm accurate placement.  The  x-ray pictures below illustrate the labrum being outlined with contrast. There are two pictures one of which is looking from the side where you can see the thin black line outlining the labrum and an oblique view in which you are looking down into the cup.

Oblique View of Labral Injection

Oblique View of Labral Injection

Lateral View of Labral Injection

Lateral View of Labral Injection

If a tear is present, a patient’s own stem cells can then be injected.  Regenexx allows a patient to have their own expanded mesenchymal stem cells (MSC)  injected directly into the damaged area.  Mesenchymal stem cells will differentiate into the cartilage which makes up the labrum.

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January 17, 2009

Rehabilitation from Shoulder Surgery

Patients with tears in the labrum, biceps tendon and inferior glenohumeral ligament often undergone surgery. Tears to the labrum, the fibrous tissue that surrounds the glenoid socket, involve cutting and removing the damaged tissue. If the tendon is torn it is commonly reattached using absorbable tacks, wires, or sutures.

glenoid-labrum-without-ligaments

Rehabilitation can be slow and painful.  After surgery the shoulder is immobilized in a sling for 3 to 4 weeks. During this time there can be loss of muscle strength and tone. Physical therapy aims to restore flexibility and muscle strength which requires weeks of therapy and time.

Ligaments, tendons and the labrum can be repaired using cell stem therapy. Regenexx enables patients to use their own stem cells to repair injuries in the shoulder. Regenexx is a simple needle in-needle out procedure which allows the patient to avoid the risks associated with surgery, anesthesia and the time consuming and painful rehabilitative process associated with surgical options.

To see how stem cell therapy can be used for rotator cuff tears please click video.

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Shoulder Joint Tears

The shoulder joint is compromised of three bones: the clavicle (collar bone), the scapula (shoulder blade) and the humerus. The humerus rests in a socket called the glenoid.

shoulder-joint

The labrum is a soft fibrous tissue rim that surrounds the socket thereby stabilizing the shoulder joint. The labrum is also the site of attachment of several ligaments.

beautiful-picture-of-glenoid-labrum

glenoid-labrum

Tears in the labrum can cause pain, catching, locking, popping, grinding, loss of range of motion and weakness.

Labrum tears are located either above (superior) or below (inferior) the middle of the glenoid socket. A tear above the middle of the socket is referred to as a SLAP (superior labrum, anterior to posterior) lesion. It can be associated with tears in the biceps tendon.

Labrum tears below the middle of the glenoid socket are called a Bankart lesion. This lesion can be associated with tears in the inferior glenohumeral ligament.

Treatment typically involves shoulder surgery where the “damaged” labrum is removed and torn tendons are reattached with suture or wires.

Rather than cutting out the torn portion of the labrum why not regenerate it? Patients now how have that option through Regenexx where their own stem cells are injected into the area of damage to regenerate the injured tissue. Regenexx is a simple needle in-needle out procedure.

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