ShoulderSurgical treatment of isolated type II superior labrum anterior-posterior (SLAP) lesions: repair versus biceps tenodesis
Section snippets
Patient selection
A retrospective analysis was performed of all patients who had undergone a superior labral repair or biceps tenodesis for an isolated type II SLAP lesion by the senior author (J.J.P.W.) between January 2008 and March 2011. Patients were included in the study if they showed both clinical and radiologic evidence of an isolated type II SLAP lesion. Patients with other types of SLAP lesions, such as types I, III, and IV, were excluded from the study. In addition, patients who had a concomitant
Characteristics of superior labral repair and biceps tenodesis groups
In the biceps tenodesis group, 13 patients (87%) had clear intraoperative evidence of degenerative superior labrums. In the remaining 2 patients, the superior labrum appeared to be of reasonable quality and tenodesis was performed based on the patients’ ages (56 years and 59 years). Of the 15 patients, 13 (93%) were aged older than 35 years. Concomitant subacromial decompression was performed in 11 patients (73%), and 1 patient had a distal clavicle excision.
All patients in the labral repair
Discussion
In this study, we hypothesized that both superior labral repair and biceps tenodesis could provide significant improvements in functional outcome, pain, and overall satisfaction if performed in appropriately selected patients. It has been the senior author’s preference to perform arthroscopic SLAP repairs for patients who were generally younger (<35 years) and/or those in whom healthy labral tissue was found at the time of arthroscopy. In contrast, for patients who were generally older (>35
Conclusions
In this study, we have shown that both superior labral repair and biceps tenodesis can provide good to excellent results with high patient satisfaction if performed in appropriately selected patients. Hence, we believe that each patient must be considered individually when one is deciding the appropriate form of management. It is our current treatment algorithm that in younger patients (<35 years) who are active and/or show healthy-looking labral tissue at the time of arthroscopy, SLAP repair
Disclaimer
The authors, their immediate families, and any research foundations with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article.
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The Partners Healthcare Institutional Review Board has reviewed and approved this study (IRB No. 2012P000567).