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My shoulder is clicking and clunking but it doesn't hurt. I had surgery five years ago (a Bankart procedure) for a torn labrum. Is the clicking a sign that the labrum is torn again?

The Bankart procedure is done to reattach the labrum (a rim of fibrous cartilage) when it is torn away from the shoulder socket. When the force of injury is enough to tear the labrum, a piece of bone attached to the labrum comes with it. The layers of soft tissue around the labrum (ligaments, joint capsule, tendons) are also damaged and must be stitched back together layer by layer. Clicking in the shoulder could be from several different causes. There may be a frayed edge of the labrum that is getting caught between the head of the humerus (upper arm bone) and the socket. There could be a bone spure or a bit of swelling from arthritis causing this symptom. A recent study done on patients with recurrent (repeated) anterior (forward) shoulder dislocations showed that one-fourth of the patients had early (mild) arthritic changes that were present in the shoulder before surgery. Only seven per cent of those cases actually showed up on X-rays. That's because the most frequent sign of early arthritis was bone spurs developing where the labrum attaches to the shoulder socket. This type of change doesn't appear on X-rays until the spur formation is much more advanced. The surgeons confirmed these changes when looking at the joint during the Bankart procedure. It could be something else altogether. An accurate diagnosis will require an orthopedic examination and possibly some imaging studies.

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