Should you get a second opinion before labral tear surgery?

Short answer: Often, yes. Labral tears are common on MRI in people with no pain at all, and the right operation changes with age. A repair that suits a 20-year-old thrower can be the wrong choice at 45.

When a second opinion changes the plan

• The tear may be normal wear. In people aged 45 to 60 with no shoulder pain, radiologists reported superior labral tears in 55 to 72 percent.
• You are past your mid-30s and were offered a SLAP repair. In a study of 179 SLAP repairs, 36.8 percent failed, and patients older than 36 were about three and a half times more likely to fail.
• A biceps tenodesis may be the better operation. One study found 87 percent returned to their previous sport after tenodesis against 20 percent after SLAP repair.

Questions to ask your surgeon

1. Is the labral tear the cause of my symptoms?
2. Is this a SLAP tear or an instability (Bankart) tear?
3. Would a biceps tenodesis suit me better than a repair?
4. Has my shoulder dislocated, and is there bone loss?
5. What does return to sport look like?

What your imaging should show

Where the tear sits (top of the socket or front), whether the shoulder has dislocated, any bone loss on the socket, and the biceps anchor. An MR arthrogram is sometimes needed for detail.

What the research shows

For instability tears, long-term data on arthroscopic Bankart repair at 10 or more years show re-dislocation rates comparable to open surgery, around 18 percent, which is why bone loss and remplissage are assessed up front.

Get a second opinion without the trip

If you already have an MRI, Dr. Patrick Denard can review your images and report remotely and record a narrated video explaining what they show and what he would recommend, typically within 48 hours, for $250. Start a remote MRI review. To be seen in person in Medford or Grants Pass, request an appointment or call 541-608-2595.

Learn more about labral tear surgery at Oregon Shoulder Institute.

Frequently asked questions

Can a torn labrum heal on its own?

Degenerative fraying often settles with therapy. Tears from dislocation in young athletes usually do not heal back in place.

Is a biceps tenodesis a bigger operation?

It is a common, reliable procedure, and in older patients it often gives a more predictable return to activity than a SLAP repair.

Related reading

• Can a Torn Labrum in the Shoulder Heal on Its Own?
• Can You Play Baseball after SLAP Repair?
• What Are the Long-Term Outcomes of Arthroscopic Bankart Repair?

This page is for education and is not a substitute for an exam. Our surgeons have performed more than 10,000 surgeries, and more than 95 percent of patients go home the same day.