Superior labrum, anterior and posterior (SLAP) lesions are common and identified in up to 26% of shoulder arthroscopies, with the greatest risk factor appearing to be overhead sporting activities. Symptomatic patients are treated with physical therapy and activity modification. However, after the failure of non-operative measures or when activity modification is precluded by athletic demands, SLAP tears have been managed with debridement, repair, biceps tenodesis or biceps tenotomy. Recently, there have been noticeable trends in the operative management of SLAP lesions with older patients receiving biceps tenodesis and younger patients undergoing SLAP repair, largely with suture anchors. For overhead athletes, particularly baseball players, SLAP lesions remain a difficult pathology to manage secondary to concomitant pathologies and unpredictable rates of return to play. As a consequence, the most appropriate surgical option in elite throwers is controversial. The objective of this current concepts review is to discuss the anatomy, mechanism of injury, presentation, diagnosis and treatment options of SLAP lesions and to present current literature on outcomes affecting return to sport and work.
- sports medicine
- athletic injuries
- orthopedic procedures
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Contributors MRL contributed to the conception, drafting, revising and final approval of the manuscript. MRM and BCH contributed to the revising of the manuscript and final approval of the manuscript. AAR, EC and ADM contributed to the conception, revising and final approval of the manuscript. All authors attest to the accuracy and integrity of the complete manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests AAR provides research support for Arthrex, Inc. and Northwell Health. AAR is a paid consultant for Arthrex, Inc. and Paragen Technologies. AAR receives royalties from Saunders/Mosby-Elsevier. N.N.V. and Arthrex, Inc. AAR is a stockholder in Healthpoint Capital, DuPage Medical Group and Paragen Technologies. AAR provides publisher support for Slack, Inc., Orthopedics Today and Saunders/Mosby-Elsevier. N.N.V. and is on the editorial boards of Techniques in Shoulder and Elbow, Techniques in Sports Medicine, Sports Health and Orthopedics and is the chief medical editor of Orthopedics Today. EC is a paid presenter or speaker for DePuy, Smith & Nephew and Stryker as well as a paid consultant for Johnson & Johnson and research support for Smith & Nephew. EC is a board or committee member for the European Society for Surgery of the Shoulder and Elbow as well as the International Society of Arthroscopy, Knee Surgery, and Orthopaedic Sports Medicine. EC is also a member of the editorial or governing board of the Journal of Shoulder and Elbow Surgery. ADM is a research support and consultant for Arthrex, Inc.
Provenance and peer review Commissioned; externally peer reviewed.
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