Introduction and importance The two major etiologies of shoulder superior labral tears anterior to posterior (SLAP) are traumatic and degenerative processes. Bucket handle tears of the superior labrum represent one-third of labral lesions. However, in this article, we present a double bucket handle tear which has been reported once in the literature. Presentation of case A 25-year-old male presented with complaint of chronic pain in his right shoulder with a remote history of traumatic dislocation. Physical examination revealed a positive apprehension test. Shoulder magnetic resonance imaging (MRI) showed a superior labral tear with a Hill-Sach lesion. Arthroscopy showed a double bucket handle tear of superior labrum and mild biceps tendonitis along with Bankart lesion. The tear was resected and the Bankart lesion was repaired followed by supervised physical therapy. Good clinical outcomes in form of resolution of pain and shoulder instability at six months were obtained. Discussion SLAP tears are common shoulder lesion that is reported differently in the literature. Arthroscopic studies had reported the incidence between 3.9%-11.8. The diagnosis of such lesion relies on the clinical presentation and imaging. Knesek et al. classified SLAP lesions based on the integrity of the biceps anchor and the type of labral tear (Knesek et al., 2013). The standard treatment of symptomatic SLAP lesions is Arthroscopic debridement. However, non-operative management was described in the literature. Conclusion Double bucket handle injuries of the superior labrum are reported in literature once. These lesions can be treated with arthroscopic debridement and Bankart repair and followed by supervised physical therapy.

To measure the posterior slope of the tibia among the healthy Saudi population using Magnetic Resonance Imaging (MRI). A retrospective study review of 151 knee MRIs at King Khaled University Hospital, Riyadh, Saudi Arabia. All patients with no previous surgical intervention to their knees and did not suffer any bone injury around the knee were included. Three different orthopedic physicians (two senior residents, one orthopedic fellow) measured the posterior tibial slope (PTS) angle for all patients, and their average was taken for all readings using a sagittal T2 MRI cut. Patients with a history of previous surgical intervention to the knee joint, trauma involving distal femur or proximal tibia, osteoarthritis and inflammatory arthritis, and congenital deformities were excluded from the study. The mean age of patients was 28.15 in a range of 15-50 years. The posterior tibial slope mean and the median and the mode were 8.76, 8.73, 7.53, respectively. In addition, the mean angle (degree) in females was 9.69±4.02 and 8.76±4.15 in males. The Maximum and the minimum posterior slope angle calculated in these patients were respectively 19.73 and 0.3 degrees. Our findings are that the mean posterior tibia slope among the Saudi population is 8.76˚. The results showed the difference of PTS in Saudi people comparing to deferent communities. The association between the numbers of the posterior tibial slope with gender was tested and no significant correlation. In this study, we did not calculate weight and height in the cases as independent factors. Because of that, upcoming studies might consider these factors.