A Meta-analysis Examining Clinical Test Utility for Assessing Superior Labral Anterior Posterior Lesions

Meserve, Brent B.; Cleland, Joshua A.; Boucher, Thomas

doi:10.1177/0363546508325153

Cited by 58 publications

(29 citation statements)

References 43 publications

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“…O'Brien's test was classically described for the diagnosis of SLAP tears [18], but recent studies suggest it is useful for identifying labral pathology in general in conjunction with other provocative tests [11,16]. O'Brien's test is believed to produce pain by applying tension across the biceps labral complex and by tensioning the capsule again an unstable labrum [18].…”

Section: Discussionmentioning

confidence: 99%

‘Batter’s Shoulder’: Can Athletes Return to Play at the Same Level After Operative Treatment?

Wanich

Dines

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background Batter's shoulder has been defined as posterior subluxation of the lead shoulder during the baseball swing. However, it is unclear whether or how frequently patients may return to play after treatment of this uncommon condition. Questions/purposes We therefore determined the rate of return to play after operative treatment for Batter's shoulder and whether ROM was restored. Methods We retrospectively reviewed the records of 14 baseball players diagnosed with Batter's shoulder. Four played professionally, six were in college, and four were in varsity high school. The average age was 20.3 years (range, 16-33 years). All had physical examinations and MRI findings consistent with posterior labral tears involving the lead shoulder. Treatment involved arthroscopic posterior labral repair (n = 10), débridement (n = 2), or rehabilitation (n = 2). The minimum followup was 18 months (average, 2.8 years; range, 18-64 months).

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Section: Discussionmentioning

confidence: 99%

‘Batter’s Shoulder’: Can Athletes Return to Play at the Same Level After Operative Treatment?

Wanich

Dines

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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“…However, authors of 3 previous studies and a meta-analysis indicated poor diagnostic utility of the anterior slide for either confirming or excluding a SLAP lesion. 6,7,15,20 Our study indicated that the anterior slide test probably has limited diagnostic utility as a single test. In light of our findings and those of previous investigators, 6,7,15,20 the anterior slide test should be used with caution as a single test to diagnose type II to IV SLAP lesions.…”

Section: Disclaimermentioning

confidence: 81%

“…7,9,10,12 In systematic reviews of studies in which tests for SLAP lesions were investigated, authors have indicated that no single test or combination of tests consistently has demonstrated adequate diagnostic utility for identifying SLAP lesions. 13,14 However, in their meta-analysis of SLAP lesion tests using summary receiver operating characteristic (ROC) curves, Meserve et al 15 reported that the active compression and crank tests had better diagnostic utility than the anterior slide test for determining SLAP lesions; the anterior slide test was not recommended for use.…”

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confidence: 99%

Diagnostic Accuracy of History and Physical Examination of Superior Labrum Anterior-Posterior Lesions

Michener

Doukas

Murphy

et al. 2011

Journal of Athletic Training

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Context: Type I superior labrum anterior-posterior (SLAP) lesions involve degenerative fraying and probably are not the cause of shoulder pain. Type II to IV SLAP lesions are tears of the labrum.Objective: To determine the diagnostic accuracy of patient history and the active compression, anterior slide, and crank tests for type I and type II to IV SLAP lesions.Design: Cohort study. Setting: Clinic. Patients or Other Participants: Fifty-five patients (47 men, 8 women; age = 40.6 ± 15.1 years) presenting with shoulder pain.Intervention(s): For each patient, an orthopaedic surgeon conducted a clinical examination of history of trauma; sudden onset of symptoms; history of popping, clicking, or catching; age; and active compression, crank, and anterior slide tests. The reference standard was the intraoperative diagnosis. The operating surgeon was blinded to the results of the clinical examination.Main Outcome Measure(s): Diagnostic utility was calculated using the receiver operating characteristic curve and area under the curve (AUC), sensitivity, specificity, positive likelihood ratio (+LR), and negative likelihood ratio (-LR). Forward stepwise binary regression was used to determine a combination of tests for diagnosis.Results: No history item or physical examination test had diagnostic accuracy for type I SLAP lesions (n = 13). The anterior slide test had utility (AUC = 0.70, +LR = 2.25, -LR = 0.44) to confirm and exclude type II to IV SLAP lesions (n = 10). The combination of a history of popping, clicking, or catching and the anterior slide test demonstrated diagnostic utility for confirming type II to IV SLAP lesions (+LR = 6.00).Conclusions: The anterior slide test had limited diagnostic utility for confirming and excluding type II to IV SLAP lesions; diagnostic values indicated only small shifts in probability. However, the combination of the anterior slide test with a history of popping, clicking, or catching had moderate diagnostic utility for confirming type II to IV SLAP lesions. No single item or combination of history items and physical examination tests had diagnostic utility for type I SLAP lesions.

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“…16,25,[42][43][44][45] However, 2 tests for the examination of SLAP tears deserve further analysis, provided later. The influence of combining tests to increase clinical utility is also summarized later.…”

Section: Superior Labrum Anterior and Posterior Lesionsmentioning

confidence: 99%

Examination of the Biceps Tendon

McFarland

Borade

2016

Clinics in Sports Medicine

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A Meta-analysis Examining Clinical Test Utility for Assessing Superior Labral Anterior Posterior Lesions

Cited by 58 publications

References 43 publications

‘Batter’s Shoulder’: Can Athletes Return to Play at the Same Level After Operative Treatment?

‘Batter’s Shoulder’: Can Athletes Return to Play at the Same Level After Operative Treatment?

Diagnostic Accuracy of History and Physical Examination of Superior Labrum Anterior-Posterior Lesions

Examination of the Biceps Tendon

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