Age-related Outcome of Arthroscopic Repair of Isolated Type II Superior Labral Anterior to Posterior Lesions

Abstract

Background: Repair of superior labral anterior to posterior (SLAP) lesion in patients older than 40 years is controversial. The purpose of this study was to evaluate clinical outcomes of arthroscopic repair of SLAP lesions between younger and older patient groups. Methods: We reviewed 50 patients with isolated type II SLAP lesions who underwent arthroscopic repair. Patients were divided into 2 groups: group 1 included 20 patients aged <40 years, and group 2 included 30 patients aged ≥40 years. Functional outcome at the final follow-up was assessed using a visual analog scale for pain and satisfaction, American Shoulder and Elbow Surgeons form, Constant score, University of California at Los Angeles score, and periodic change in range of motion (ROM). Anatomical outcome was evaluated using computed tomography (CT) arthrography at least 1 year after surgery. Results: No significant differences in functional scores or postoperative ROM were observed between the 2 groups. In group 2, later recovery of ROM (forward flexion, p=0.025; internal rotation, p=0.034) and lower satisfaction score (p=0.06) were observed for atraumatic patients (n=16) compared to patients with traumatic injury (n=14). Fifteen patients in group 1 (15/17, 88%) and 21 patients in group 2 (21/26, 81%) demonstrated a healed labrum on postoperative CT arthrography, and this difference was not significant. Conclusions:The results of this study suggest that arthroscopic repair of type II SLAP lesions can yield good functional and anatomical outcomes regardless of age, if patient selection is adequate. However, the delay in ROM recovery and lower satisfaction, particularly in older patients without traumatic injury, should be considered. (Clin Shoulder Elbow 2015;18(1):36-42)

Posterior repair of isolated type 2 superior labrum anterior–posterior lesion prevents external rotation deficiency: long-term outcome study

“…SLAP lesion characteristics differ according to age, with a bimodal distribution in those aged 20–29 years and 40–49 years [32]. The pathogenesis, biological healing potential, superior labrum vascularity, and activity level differ in both age groups [11, 20] [1].…”

“…Andrews et al first described superior glenoid labrum tears in 1985 [3], and Snyder et al coined the term superior labrum anterior‐to‐posterior (SLAP) lesion and described the corresponding classifications in 1990 [31]. SLAP lesions can cause shoulder pain and function limitations, especially during overhead activities, such as throwing [1, 10, 20, 21, 32]. Surgical SLAP lesion repair is recommended if patients do not recover after conservative treatment [7, 10, 31, 32].…”