Is timing of superior labrum anterior to posterior (SLAP) repair important? A cohort study evaluating the effect of the duration of symptoms prior to surgery on the outcomes of patients who underwent type II SLAP repair

2020 ◽  
Vol 04 (01) ◽  
pp. 10
Author(s):  
Geoffrey Murphy
2021 ◽  
pp. 175857322110158
Author(s):  
Geoffrey T Murphy ◽  
Patrick H Lam ◽  
George AC Murrell

Background The management of superior labrum anterior to posterior (SLAP) tears is somewhat controversial. It is unclear if the length of time between symptom onset and surgery affects SLAP repair outcomes. Methods Sixty-one SLAP repairs were retrospectively reviewed pre-operatively and post-operatively at 1, 6, 24 weeks, and > 2 years post-surgery. Patients were allocated to an ‘early repair’ or ‘late repair’ group based on time between symptom onset and surgery. Results Of the 61 patients, 22 patients had surgery within six months of symptom onset. Pre-operatively, ‘late repair’ patients played a higher level of sport than ‘early repair’ patients prior to injury. Post-operatively, both groups had similar outcomes up to six months, though at six months ‘early repair’ patients reported a higher level of work than ‘late repair’ patients (p = 0.01). At > 2 years after surgery, ‘early repair’ patients had reduced pain and difficulty with overhead activities (p = 0.002), less stiffness (p = 0.001) and were more satisfied than ‘late repair’ patients (p = 0.04). Conclusions Up to six months post-operatively, the time between symptom onset and surgery has limited effect on functional outcomes. However, at > 2 years after surgery, earlier repairs ( < 6 months) are interestingly associated with better functional outcomes. Further studies are required to determine if this is a causal relationship.


2020 ◽  
pp. 219256822092219
Author(s):  
Alexander von Glinski ◽  
Ariel Takayanagi ◽  
Christopher Elia ◽  
Basem Ishak ◽  
Mishan Listmann ◽  
...  

Study Design: Retrospective cohort study Objectives: The study aims to evaluate anterior cervical discectomy and fusion (ACDF) in the treatment of patients with ossification of the anterior longitudinal ligament (OALL). Methods: We retrospectively reviewed cases performed at our institution between January 2015 and December 2018; adult (age ≥18 years) patients who underwent anterior cervical decompression and fusion in the presence of dysphagia and OALL. Ten patients (9 male, 1 female, mean age 64.4 years) with OALL who underwent ACDF were included. Charts were reviewed for demographics and comorbidities. Primary outcomes assessed were intra- and postoperative complications. Secondary outcomes were fusion rates, instrumentation failure, postsurgical instability/deformity, and readmission rates. Results: The average duration of symptoms prior to surgery was 12.3 months. All patients presented with dysphagia (mean Bazaz score 2.0). The average number of levels with OALL was 4.7 (±1.67). All patients underwent ACDF and 3 patients underwent additional posterior cervical fusion for kyphotic deformity correction or when extensive laminectomy was required. We did not encounter any intraoperative complications. Eight patients (72%) had solid fusion demonstrated on the lateral x-rays and no evidence of progressive kyphotic deformity. We did not encounter any instrumentation failure or loosening. Two patients developed recurrence of dysphagia (Bazaz scores 2 and 3 respectively). Conclusion: ACDF for OALL with dysphagia and concomitant myelopathy in our small series of 10 patients demonstrate good fusion and clinical outcomes. Larger studies will be necessary to determine the optimal treatment for patients with dysphagia due to OALL.


Orthopedics ◽  
2013 ◽  
Vol 36 (6) ◽  
pp. e273-e728 ◽  
Author(s):  
Anil K. Gupta ◽  
Benjamin Bruce ◽  
Emma L. Klosterman ◽  
Frank McCormick ◽  
Joshua Harris ◽  
...  

2016 ◽  
Vol 33 (5) ◽  
pp. 435-443 ◽  
Author(s):  
Chun-Yuan Lin ◽  
Yu-Hsin Wu ◽  
Hong-Song Wang ◽  
Ping-Kun Chen ◽  
Yuan-Fu Lin ◽  
...  

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