A biomechanical comparison of repair techniques in posterior type II superior labral anterior and posterior (SLAP) lesions

Restoration of Labral Anatomy and Biomechanics After Superior Labral Anterior-Posterior Repair

“…However, the only significant differences were seen at clinical failure, which was defined in this study, as well as many previous studies, as being 2 mm. 8,9,20,28 We found that the simple repair construct had a higher load and energy absorbed at clinical failure only. While statistical significance was achieved, the absolute difference was small and unlikely to reflect any clinical significance.…”

“…However, the simple technique conferred higher absolute loads to clinical and ultimate failure, and it was suggested that the mattress technique was inferior compared with the simple. 28 During our assessment of labral strain with video analysis, we found that our reproduction of biceps loading in a physiological direction correlated with the highest forces in the posterosuperior labrum (between 10:30 and 11:30). This increased force on the posterior labrum accurately reflects what has been described previously as the ''peelback'' mechanism.…”

“…This lesion was later termed SLAP and further classified by Snyder et al in 1990. 6,25 A type II SLAP lesion is by far the most common, accounting for about 50% of all SLAP lesions, 2,16,24,28 and surgical repair is the treatment of choice. A type II SLAP lesion is defined as an avulsion of the superior labrum and the biceps anchor from the glenoid.…”

Arthroscopic Repair of Inferior Labrum Anterior to Posterior Lesions of the Shoulder Using a Combined “Double-Pulley” Simple Knot Technique

“…On each anchor, one of the sutures is used in a simple vertical knot configuration to reproduce the tension of the anterior band and posterior band of the inferior glenohumeral ligament, respectively, and to produce strong stable initial fixation to the anterior-inferior and posterior-inferior labrum. 14 The double-pulley technique is used to repair the inferior labrum between the anterior and posterior bands of the inferior glenohumeral ligament (Table 2). There are 3 main advantages to using the double-pulley technique in this setting (Table 3).…”

Diagnosis and management of superior labrum anterior posterior lesions in overhead athletes

“…There have been a number of biomechanical evaluations on a variety of suture anchor locations and suture configurations 68 113 114. One investigation found simple suture configuration to be superior to mattress type113 while another found that one anterior and one posterior simple suture configuration was equivalent to two posterior simple sutures in resisting ‘peel-back’ forces 68.…”