Clinical outcomes of non-operative treatment for patients presenting SLAP lesions in diagnostic provocative tests and MR arthrography

Shin, Sang Jin; Lee, Juyeob; Jeon, Young-Chan; Ko, Young Won; Kim, Rag Gyu

doi:10.1007/s00167-016-4226-7

Cited by 13 publications

(6 citation statements)

References 28 publications

(39 reference statements)

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“… 10 11 Furthermore, satisfactory clinical outcomes have been reported for non-operative intervention as the primary treatment of SLAP lesions. 23 24 Because biceps tenodesis and non-operative intervention have gained popularity for the management of SLAP lesions, the incidence of SLAP repair in Korea is believed to have decreased since 2012. An increasing frequency of SLAP repairs was also reported in the United States before 2010 6 8 9 ; however, a decreasing trend was noted in more recent studies.…”

Section: Discussionmentioning

confidence: 99%

National Trends in the Repair of Isolated Superior Labral Tear from Anterior to Posterior in Korea

Oh²,

Jeong

et al. 2020

J Korean Med Sci

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Background: The optimal treatment for superior labral tear from anterior to posterior (SLAP) lesions is controversial. Thus, we aimed to investigate the national surgical trends in isolated SLAP repair in Korea. Methods: We analyzed a nationwide database from the Korean Health Insurance Review and Assessment Service from 2008 to 2017. We investigated the trends in SLAP repair by time, sex, age, and the type of health care institution. Results: From 2008 to 2017, 27,850 isolated SLAP repairs were identified. Age-adjusted incidence rate of isolated SLAP repair increased by 692% from 1.07/100,000 in 2008 to 8.48/100,000 in 2012 (P = 0.005). However, the incidence rate declined significantly after 2012 (P = 0.032) and was 5.28/100,000 in 2017. Sex-specific incidence rate of isolated SLAP repair was 2.3 times higher in men than in women. The decline since 2012 was most evident in patients aged ≥ 40 years (P = 0.01); however, the incidence rates of isolated SLAP repair during the study period were similar between patients aged ≥ 40 years and those aged < 40 years. Moreover, hospitals with 30-100 beds had the greatest change in the number of isolated SLAP repair cases. Conclusion: In Korea, the incidence of isolated SLAP repair increased dramatically until 2012; since then, it has declined. Although the decrease in isolated SLAP repair later in the study was evident in those aged ≥ 40 years, the incidence rate was still relatively high in patients aged ≥ 40 years.

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Section: Discussionmentioning

confidence: 99%

National Trends in the Repair of Isolated Superior Labral Tear from Anterior to Posterior in Korea

Oh²,

Jeong

et al. 2020

J Korean Med Sci

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“…5,6 In a prospective case series of 46 patients, Shin et al found that three months of non-operative treatment improved patient's American shoulder and elbow surgeons (ASES) scores and Constant scores from baseline by two years after commencement of non-operative treatment. 7 Similarly, Edwards et al, in a case series of 19 patients, found that 3-6 months of non-operative treatment significantly improved patient ASES scores compared with prior to treatment. 8 However, in both studies, several patients (15% and 51%, respectively) still required surgery after this period of non-operative treatment.…”

Section: Introductionmentioning

confidence: 88%

“…8 However, in both studies, several patients (15% and 51%, respectively) still required surgery after this period of non-operative treatment. 7,8 SLAP repair is a commonly advocated surgical treatment for SLAP tears. It involves the reattachment of the superior labra to the glenoid rim.…”

Section: Introductionmentioning

confidence: 99%

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Is timing of superior labrum anterior to posterior (SLAP) repair important? A cohort study evaluating the effect of the duration of symptoms prior to surgery on the outcomes of patients who underwent type II SLAP repair

2021

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Background The management of superior labrum anterior to posterior (SLAP) tears is somewhat controversial. It is unclear if the length of time between symptom onset and surgery affects SLAP repair outcomes. Methods Sixty-one SLAP repairs were retrospectively reviewed pre-operatively and post-operatively at 1, 6, 24 weeks, and > 2 years post-surgery. Patients were allocated to an ‘early repair’ or ‘late repair’ group based on time between symptom onset and surgery. Results Of the 61 patients, 22 patients had surgery within six months of symptom onset. Pre-operatively, ‘late repair’ patients played a higher level of sport than ‘early repair’ patients prior to injury. Post-operatively, both groups had similar outcomes up to six months, though at six months ‘early repair’ patients reported a higher level of work than ‘late repair’ patients (p = 0.01). At > 2 years after surgery, ‘early repair’ patients had reduced pain and difficulty with overhead activities (p = 0.002), less stiffness (p = 0.001) and were more satisfied than ‘late repair’ patients (p = 0.04). Conclusions Up to six months post-operatively, the time between symptom onset and surgery has limited effect on functional outcomes. However, at > 2 years after surgery, earlier repairs ( < 6 months) are interestingly associated with better functional outcomes. Further studies are required to determine if this is a causal relationship.

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“…While repair of Type 2 SLAP lesions was 9.4% of all applicants’ shoulder procedures performed by ABOS Part 2 candidates from 2003 to 2008 [ 20 ], the rate has been diminishing as results of clinical studies indicate that success rates in overhead athletes and in middle-aged patients are lower than expected [ 19 , 21 , 22 ]. Alternative surgical treatments such as bicep tenodesis or tenotomy for the middle-aged population and those with rotator cuff tears have emerged as options preferred by some authors [ 23 , 24 ] and may be applicable for younger athletes as well [ 25 - 27 ]. Others recommend simple debridement of unstable labral tissue in overhead athletes.…”

Section: Introductionmentioning

confidence: 99%

Superior Labral Anterior to Posterior Tear Management in Athletes

Mathew¹,

Lintner²

2018

TOORTHJ

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Background:The diagnosis and treatment of Superior Labrum Anterior to Posterior (SLAP) tears have been evolving and controversial. The lack of clear diagnostic criteria on physical examination, Magnetic Resonance Imaging (MRI), and arthroscopic evaluation clouds the issue. The high rate of MRI diagnosed SLAP lesions in the asymptomatic population of athletes and non-athletes warrants consideration when planning treatment for those with shoulder pain.Objective:To provide information on the evaluation, diagnosis and management of SLAP tears in athletes.Methods:The results of a structured non-operative rehabilitation program are discussed and compared to traditional surgical techniques. The evolution of the author’s treatment algorithm is presented. Results: The successful return to overhand throwing is more common with non-operative treatment than with surgical.Conclusion:A rehabilitation program focused on stretching the posterior capsule and correcting scapular posture is more successful than surgery for most throwers with SLAP lesions.

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Clinical outcomes of non-operative treatment for patients presenting SLAP lesions in diagnostic provocative tests and MR arthrography

Cited by 13 publications

References 28 publications

National Trends in the Repair of Isolated Superior Labral Tear from Anterior to Posterior in Korea

National Trends in the Repair of Isolated Superior Labral Tear from Anterior to Posterior in Korea

Is timing of superior labrum anterior to posterior (SLAP) repair important? A cohort study evaluating the effect of the duration of symptoms prior to surgery on the outcomes of patients who underwent type II SLAP repair

Superior Labral Anterior to Posterior Tear Management in Athletes

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