Arthroscopic Repair of Batter’s Shoulder

Background: Batter’s shoulder is a condition in which the posterior labrum is typically torn during the baseball swinging motion, producing a traumatic tear and posterior instability. The injury commonly occurs in the batter’s lead shoulder due to repetitive microtrauma, raising concern for switch-hitters due to the cumulative stress of throwing and swinging on the lead shoulder. Instability is commonly caused by a posterior humeral force and relative shoulder adduction, which is most prevalent during a swing attempt at a low and outside pitch. Indications: Damage to the labrum during the acute traumatic event can cause residual pain and recurrent instability of the shoulder. Indications include failed conservative management. The patient demonstrated a full-thickness longitudinal tear that was grossly unstable with gentle probing. Technique Description: After establishing presence of an unstable posterior labral tear during diagnostic arthroscopy, a 7-o’clock portal is established for the labral repair. A knotless suture anchor construct was utilized for its low-profile features. Care is taken to avoid both tangling of sutures and overtensioning of the repair. Results: Patients return to live batting practice at 6 months postoperatively and most patients return to the same level of play following surgical management. Discussion/Conclusion: Avoid overtightening of labral repair and subsequent loss of range of motion. Use of a low-profile knotless suture anchor is the senior author’s preferred method of surgical management. A majority of patients surgically managed for unstable posterior labral injuries return to the same level of play.