Outcomes of type II superior labrum, anterior to posterior (SLAP) repair: Prospective evaluation at a minimum two-year follow-up

Abstract

Hypothesis Patients with type II superior labrum, anterior to posterior (SLAP) lesions will have improved function and decrease pain at a minimum two years after arthroscopic SLAP repair using bioabsorbable suture anchor fixation. Materials and Methods The study population consisted of 48 patients who underwent arthroscopic SLAP repair. Subjective shoulder scores, range of motion, and strength (post-operative only) were assessed pre-operatively and at a minimum of two years post-operatively. Results At an average of 3.4 years following surgery, statistically significant improvement was seen in ASES, UCLA, SST, CADL, VAS, and SF-12 physical outcome scores. Improvements were made in forward flexion, abduction, external rotation, and internal rotation. Subgroup analysis of non-athletes, non-overhead athletes, recreational overhead athletes, and collegiate overhead athletes showed pre- to post-operative improvements in subjective outcomes scores. Overhead laborers and non-laborers subgroups also showed pre- to post-operative improvements in subjective shoulder scores. Discussion On the basis of this data, arthroscopic SLAP repair of type II lesions with bioabsorbable suture anchors provides a significant improvement in functional capacity and pain relief. No differences were seen between the outcomes of non-athletes, non-overhead athletes, recreational overhead athletes, and collegiate overhead athletes, suggesting that SLAP type II repair is successful independent of the patient’s vocation or sport. Level of Evidence IV, Case Series, Treatment Study

Return to Preinjury Levels of Participation After Superior Labral Repair in Overhead Athletes: A Systematic Review

“…1.0); however, the other group had a greater chance of successful return to full activity (OR ¼ 3.5; 95% CI ¼ 0.8, 16.3) than did baseball athletes. The 2 investigations also showed that overhead athletes (odds ¼ 1.3-2.5) and nonoverhead/other athletes (odds ¼ 2.0-5.0) both had positive odds for returning to full activity after superior labral repair with soft tissue debridement, but again the ORs favored the nonoverhead (OR ¼ 1.5; 95% CI ¼ 0.4, 6.0) 19 and other (OR ¼ 2.0; 95% CI ¼ 0.2, 19.9) groups. 18 These observations were not different, as each 95% CI contained the value 1.0.…”

“…Researchers [16][17][18][19][20][21] examining various types of overhead athletes after superior labral repair with concurrent procedures reported return to preinjury levels of participation ranging from 41% to 86%. Concurrent procedures consisted of debridement of partial-thickness rotator cuff tear or the labrum, subacromial decompression, bursectomy, or distal clavicle excision.…”

“…Researchers who categorized return to participation with limitation reported that 14% to 37% of athletes returned with limitation, 16,17,21 whereas those who focused on no return reported that 17% to 100% of athletes did not return to sport after surgery. [18][19][20][21] Using the originally reported return-to-participation rates, we generated ORs for 4 of the 6 studies that focused on labral repair with concurrent soft tissue debridement (Table 6). [17][18][19]21 The subgroupings for each study varied: authors comparing baseball and ''other'' sports, 17 overhead and nonoverhead athletes, 18,19 and only overhead athletes who underwent surgery for superior labral tears and superior labral tears with concomitant rotator cuff injury.…”

“…[18][19][20][21] Using the originally reported return-to-participation rates, we generated ORs for 4 of the 6 studies that focused on labral repair with concurrent soft tissue debridement (Table 6). [17][18][19]21 The subgroupings for each study varied: authors comparing baseball and ''other'' sports, 17 overhead and nonoverhead athletes, 18,19 and only overhead athletes who underwent surgery for superior labral tears and superior labral tears with concomitant rotator cuff injury. 21 Ide et al 17 reported that both baseball and ''other'' athletes had positive chances of returning to full participation (all odds .…”

“…The concurrentdebridement studies had an average of 8.5 more patients in the overhead-athlete groups than the same patient groups in the isolated-repair studies. [16][17][18][19][20][21] The increased number of patients undergoing labral repair with concurrent debridement inflated the odds of successful return, which could explain why the chance of full return was greater after a procedure that involved treatment to more tissue. Conversely, the data from Neri et al 21 suggested a 28 times greater chance of returning to full activity after isolated superior labral repair than after concurrent procedures.…”