Results of concomitant rotator cuff and SLAP repair are not affected by unhealed SLAP lesion

2011 ◽  
Vol 20 (1) ◽  
pp. 138-145 ◽  
Author(s):  
Joo Han Oh ◽  
Sae Hoon Kim ◽  
Sang-ho Kwak ◽  
Chung Hee Oh ◽  
Hyun Sik Gong
Keyword(s):  
Rotator Cuff ◽  
Slap Lesion ◽  
Slap Repair

scholarly journals Treatment of Type Two Slap Lesion With Anatomic Suture Anchor Repair Without Biceps Tenotomy Or Tenodesis

2018 ◽  
Vol 12 (1) ◽  
pp. 324-330 ◽  
Author(s):  
Chadwick C. Prodromos ◽  
Susan Finkle ◽  
Alexander Dawes ◽  
Ji Young Baik
Keyword(s):  
Rotator Cuff ◽  
Senior Author ◽  
Slap Lesion ◽  
Biceps Tenodesis ◽  
Concomitant Procedure ◽  
Slap Repair ◽  
Biceps Tenotomy ◽  
Biceps Anchor ◽  
Long Head

Background: Poor results after repair of type 2 SLAP tears are relatively common and some have reported better results after biceps tenodesis or tenotomy than repair. In addition, some believe that the long head of the biceps is expendable. Therefore, many now favor biceps tenotomy or tenodesis over biceps anchor repair either in all patients or in older patients, reserving SLAP lesion repair only for young athletes. Hypothesis: We hypothesized that repair of the biceps anchor of the labrum would be effective in all patients regardless of age provided that care was taken not to overtighten the labrum and that rotator cuff pain as the primary pain generator had been ruled out. Methods: All patients with type 2 SLAP lesion repair by the senior author since he began repairing them with suture anchors were prospectively evaluated. Patients with more than one other concomitant procedure, simultaneous rotator cuff repair or worker’s compensation status were excluded. Results: 77% of patients were available for minimum two year followup. No patient had subsequent surgery or manipulation under anesthesis as a result of their SLAP repair. Standardized shoulder test score increased by 4 points. Mean SANE score decreased from 53 pre-op to 14 post-op. Results were the same in those over versus under 40 years of age. Conclusion: Anatomic repair of Type 2 SLAP lesions at the biceps anchor without biceps tenodesis or tenotomy can produce good results in patients of all ages.

scholarly journals SLAP Tears

2021 ◽  
Vol 1 (3) ◽  
pp. 263502542110007
Author(s):  
Steven B. Cohen ◽  
John R. Matthews
Keyword(s):  
Rotator Cuff ◽  
Shoulder Arthroscopy ◽  
Biceps Tendon ◽  
Full Range ◽  
Contralateral Side ◽  
Highly Active ◽  
Slap Repair ◽  
Biceps Tenotomy ◽  
Labral Tears ◽  
Anterior Posterior

Background: Superior labral tears are frequently encountered during shoulder arthroscopy. Outcomes following superior labral anterior-posterior (SLAP) repairs in young athletes have been well documented. Superior labral repairs in older patient population continue to remain controversial due to concerns of postoperative complications including persistent preoperative symptoms, pain, stiffness, and higher rates of revision surgery. Indications: We present a case of a highly active 38-year-old woman who failed 1½ years of nonoperative management of a type IIB SLAP tear with extension to the posterior labrum. Her symptoms continued to limit her hobbies and work. Technique: A knotless single-anchor SLAP repair was performed along with debridement of the posterior frayed labrum. No biceps tenotomy or tenodesis was performed after full evaluation of the tendon failed to demonstrate evidence of synovitis, tendinopathy, or tear. The patient also did not have any concomitant shoulder pathology, including a rotator cuff tear or chondral lesion. Results: At 6 months, the patient had regained full range of motion similar to the contralateral side. She had returned to her normal activities and sports, including tennis. Discussion/Conclusion: Successful outcomes following SLAP repairs in patients over 35 years can be achieved, but treatment should be individualized with particular attention to concomitant pathology involving the rotator cuff, chondral surface, or biceps tendon which may require tenodesis or tenotomy.

scholarly journals Sliding or Nonsliding Arthroscopic Knots for Shoulder Surgery: A Systematic Review

2020 ◽  
Vol 8 (4) ◽  
pp. 232596712091164
Author(s):  
Caellagh D. Morrissey ◽  
Darby A. Houck ◽  
Esther Jang ◽  
Eric C. McCarty ◽  
Jonathan T. Bravman ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Clinical Outcomes ◽  
Failure Rate ◽  
Rotator Cuff Repair ◽  
Shoulder Surgery ◽  
Bankart Repair ◽  
Slap Repair ◽  
Patient Reported ◽  
Arthroscopic Shoulder Surgery ◽  
Cuff Repair

Background: Knot tying is a crucial component of successful arthroscopic shoulder surgery. It is currently unknown whether sliding or nonsliding techniques result in superior clinical outcomes. Purpose: To assess the clinical outcomes of arthroscopic sliding knot (SK)– versus nonsliding knot (NSK)–tying techniques during arthroscopic shoulder surgery, including rotator cuff repair, Bankart repair, and superior labral anterior-posterior (SLAP) repair. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic search of the PubMed, Embase, and Cochrane Library databases was performed using PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines. All English-language literature published between 2000 and 2018 reporting clinical outcomes utilizing SK- or NSK-tying techniques during rotator cuff repair, Bankart repair, and SLAP repair with a minimum 24-month follow-up was reviewed by 2 independent reviewers. Information on type of surgery, knot used, failure rate, patient satisfaction, and patient-reported outcomes was collected. Patient-reported outcome measures included the Constant-Murley score, Rowe score, and visual analog scale for pain. Study quality was evaluated using the modified Coleman Methodology Score. Results: Overall, 9 studies (6 level 3 and 3 level 4) with a total of 671 patients (mean age, 52.8 years [range, 16-86 years]; 65.7% male; 206 SK and 465 NSK) were included. There were 4 studies that reported on Bankart repair in 148 patients (63 SK and 85 NSK), 3 on SLAP repair in 59 patients (59 SK), and 2 on rotator cuff repair in 464 patients (84 SK and 380 NSK). Also, 6 studies compared knot-tying with knotless techniques (3 Bankart repair studies and 3 SLAP repair studies), while the studies reporting the outcomes of SLAP repair evaluated SK-tying techniques only. The failure rate for Bankart repair was 3.2% (2/63) for SKs and 4.7% (4/85) for NSKs. The failure rate for rotator cuff repair was 2.4% (2/84) for SKs and 6.3% (24/380) for NSKs. The failure rate for SLAP repair was 11.9% (7/59). Because of inconsistencies in outcomes and procedures, no quantitative analysis was possible. The mean modified Coleman Methodology Score for all studies was 65.1 ± 8.77, indicating adequate methodology. Conclusion: The literature on clinical outcomes using SKs or NSKs for shoulder procedures is limited to level 4 evidence. Future studies should be prospective and focus on comparing the use of SKs and NSKs for shoulder procedures to elucidate which arthroscopic knot results in superior clinical outcomes.

scholarly journals Controversies In The Surgical Management Of Shoulder Instability: Associated Soft Tissue Procedures

2017 ◽  
Vol 11 (1) ◽  
pp. 989-1000 ◽  
Author(s):  
Santos Moros Marco ◽  
José Luis Ávila Lafuente ◽  
Miguel Angel Ruiz Ibán ◽  
Jorge Diaz Heredia
Keyword(s):  
Soft Tissue ◽  
Rotator Cuff ◽  
Shoulder Instability ◽  
Full Range ◽  
Rotator Interval ◽  
Range Of Movement ◽  
Slap Repair ◽  
Rotator Cuff Injuries ◽  
Complex Anatomy ◽  
Pubmed Database

Background:The glenohumeral joint is a ball-and-socket joint that is inherently unstable and thus, susceptible to dislocation. The traditional and most common anatomic finding is the Bankart lesion (anterior-inferior capsule labral complex avulsion), but there is a wide variety of anatomic alterations that can cause shoulder instability or may be present as a concomitant injury or in combination, including bone loss (glenoid or humeral head), complex capsule-labral tears, rotator cuff tears, Kim´s lesions (injuries to the posterior-inferior labrum) and rotator interval pathology.Methods:A review of articles related to shoulder anatomy and soft tissue procedures that are performed during shoulder instability arthroscopic management was conducted by querying the Pubmed database and conclusions and controversies regarding this injury were exposed.Results:Due to the complex anatomy of the shoulder and the large range of movement of this joint, a wide variety of anatomic injuries and conditions can lead to shoulder instability, specially present in young population. Recognizing and treating all of them including Bankart repair, capsule-labral plicatures, SLAP repair, circumferential approach to pan-labral lesions, rotator interval closure, rotator cuff injuries and HAGL lesion repair is crucial to achieve the goal of a stable, full range of movement and not painful joint.Conclusion:Physicians must be familiarized with all the lesions involved in shoulder instability, and should be able to recognize and subsequently treat them to achieve the goal of a stable non-painful shoulder. Unrecognized or not treated lesions may result in recurrence of instability episodes and pain while overuse of some of the techniques previously described can lead to stiffness, thus the importance of an accurate diagnosis and treatment when facing a shoulder instability.

Paper 179: How to manage a Type II SLAP Lesion When Associated with Rotator Cuff Tear in Patients over 50?

2012 ◽  
Vol 28 (9) ◽  
pp. e440
Author(s):  
Francesco Franceschi ◽  
Umile Giuseppe Longo ◽  
Laura Ruzzini ◽  
Giacomo Rizzello ◽  
Rocco Papalia ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Slap Lesion ◽  
Type Ii ◽  
Cuff Tear

No Advantages in Repairing a Type II Superior Labrum Anterior and Posterior (SLAP) Lesion When Associated with Rotator Cuff Repair in Patients over Age 50

2007 ◽  
Vol 36 (2) ◽  
pp. 247-253 ◽  
Author(s):  
Francesco Franceschi ◽  
Umile Giuseppe Longo ◽  
Laura Ruzzini ◽  
Giacomo Rizzello ◽  
Nicola Maffulli ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Rotator Cuff Repair ◽  
Slap Lesion ◽  
Type Ii ◽  
Cuff Tear ◽  
Biceps Tenotomy ◽  
Group 2 ◽  
Cuff Repair ◽  
Group 1

Background Arthroscopic management has been recommended for some superior labrum anterior and posterior (SLAP) lesions, but no studies have focused on patients over 50 years of age with rotator cuff tear and a type II SLAP lesion. Hypothesis In patients over 50 years of age with an arthroscopically confirmed lesion of the rotator cuff and a type II SLAP lesion, there is no difference between (1) repair of both lesions and (2) repair of the rotator cuff tear without repair of the SLAP II lesion but with a tenotomy of the long head of the biceps. Study Design Randomized controlled clinical trial; Level of evidence, 1. Methods We recruited 63 patients. In 31 patients, we repaired the rotator cuff and the type II SLAP lesion (group 1). In the other 32 patients, we repaired the rotator cuff and tenotomized the long head of the biceps (group 2). Seven patients (2 in group 1 and 5 in group 2) were lost to final follow-up. Results At a minimum 2.9 years’ follow-up, statistically significant differences were seen with respect to the University of California, Los Angeles (UCLA) score and range of motion values. In group 1 (SLAP repair and rotator cuff repair), the UCLA showed a statistically significant improvement from a preoperative average rating of 10.4 (range, 6–14) to an average of 27.9 (range, 24–35) postoperatively ( P < .001). In group 2 (biceps tenotomy and rotator cuff repair), the UCLA showed a statistically significant improvement from a preoperative average rating of 10.1 (range, 5–14) to an average of 32.1 (range, 30–35) postoperatively ( P < .001) There was a statistically significant difference in total postoperative UCLA scores and range of motion when comparing the 2 groups postoperatively ( P < .05). Conclusions There are no advantages in repairing a type II SLAP lesion when associated with a rotator cuff tear in patients over 50 years of age. The association of rotator cuff repair and biceps tenotomy provides better clinical outcome compared with repair of the type II SLAP lesion and the rotator cuff.

Correlation Between American Shoulder and Elbow Surgeons and Single Assessment Numerical Evaluation Score After Rotator Cuff or SLAP Repair

2015 ◽  
Vol 31 (9) ◽  
pp. 1688-1692 ◽  
Author(s):  
Gregory Cunningham ◽  
Alexandre Lädermann ◽  
Patrick J. Denard ◽  
Omar Kherad ◽  
Stephen S. Burkhart
Keyword(s):  
Rotator Cuff ◽  
Numerical Evaluation ◽  
Evaluation Score ◽  
Slap Repair

scholarly journals Rotator Cuff Sparing Arthroscopic SLAP Repair With Knotless All-Suture Anchors

2019 ◽  
Vol 8 (9) ◽  
pp. e993-e998 ◽  
Author(s):  
Travis J. Dekker ◽  
Lucca Lacheta ◽  
Brandon Goldenberg ◽  
W. Jeffrey Grantham ◽  
Peter J. Millett
Keyword(s):  
Rotator Cuff ◽  
Suture Anchors ◽  
Slap Repair ◽  
Arthroscopic Slap Repair

scholarly journals Return to Sport After the Surgical Treatment of Superior Labrum Anterior to Posterior Tears: A Systematic Review

2019 ◽  
Vol 7 (5) ◽  
pp. 232596711984189 ◽  
Author(s):  
Hussein Abdul-Rassoul ◽  
Matthew Defazio ◽  
Emily J. Curry ◽  
Joseph W. Galvin ◽  
Xinning Li
Keyword(s):  
Systematic Review ◽  
Rotator Cuff ◽  
Systematic Reviews ◽  
Return To Sport ◽  
Biceps Tenodesis ◽  
Inclusion Criteria ◽  
Slap Repair ◽  
Arthroscopic Slap Repair

Background: Controversy exists as to the optimal treatment of superior labrum anterior to posterior (SLAP) tears in athletes. There are no systematic reviews evaluating return-to-sport (RTS) rates after arthroscopic SLAP repair and biceps tenodesis. Purpose: To compare the overall RTS rates in patients with primary type 2 SLAP tears who were managed with arthroscopic SLAP repair versus biceps tenodesis. Study Design: Systematic review; Level of evidence, 4. Methods: A review was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines by searching the MEDLINE (PubMed), Embase (Elsevier), and Cochrane Library databases. Inclusion criteria were clinical studies that evaluated RTS rates after arthroscopic SLAP repair, arthroscopic SLAP repair with partial rotator cuff debridement, and biceps tenodesis. The studies were analyzed for quality and inclusion in the final analysis. Data relevant to RTS rates were then extracted and compiled, and outcomes were compared. Results: Of the 337 studies initially identified, 15 (501 patient-athletes) met inclusion criteria. These consisted of 195 patients who underwent isolated arthroscopic SLAP repair (mean age, 31 years; mean follow-up, 3.2 years), 222 patients who underwent arthroscopic SLAP repair with partial rotator cuff debridement (mean age, 22 years; mean follow-up, 5.1 years), and 84 patients who underwent biceps tenodesis (mean age, 42 years; mean follow-up, 3.3 years). The overall RTS rates were high for all 3 procedures (SLAP repair, 79.5%; SLAP repair with rotator cuff debridement, 76.6%; biceps tenodesis, 84.5%), with biceps tenodesis having the highest overall rate. Biceps tenodesis also had the highest RTS rate at the preinjury level (78.6%) compared with SLAP repair (63.6%) and SLAP repair with rotator cuff debridement (66.7%). Conclusion: Primary arthroscopic SLAP repair, arthroscopic SLAP repair with partial rotator cuff debridement, and biceps tenodesis all provide high RTS rates. Biceps tenodesis as an operative treatment of primary SLAP lesions may demonstrate an overall higher RTS rate when compared with traditional SLAP repair in older athletes. More, higher level studies are needed that control for age, level of activity, and type of sport (overhead vs nonoverhead) to determine the efficacy of biceps tenodesis as a primary alternative to arthroscopic SLAP repair in young athletes who present with type 2 SLAP tears.

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