Quantifying the Extent of a Type II SLAP Lesion Required to Cause Peel-Back of the Glenoid Labrum—A Cadaveric Study

Effects of Zone-Specific Superior Labral Detachment on Biceps Anchor Stability

“…At the time of arthroscopy, vertical lift-off of the labrum using an arthroscopic probe, lateral displacement of the labrum into the joint with an applied downward force on the biceps tendon, and posterior "peel-back" of the labrum through the combined abduction and external rotation of the shoulder are parameters used to assess for biceps anchor displacement. 4,7,25 These directions of pull correlate with several common clinical scenarios as illustrated in Figure 1. The current literature provides no discrete scientific guidelines for the evaluation of superior glenolabral separation as it relates to biceps anchor displacement.…”

“…To aid in decision-making, the arthroscopist can use 3 parameters to assess the degree of biceps anchor stability: vertical lift-off of the labrum, displacement into the joint, and posterior peel-back. 4,7,25 As the current literature provides no discrete quantitative guidelines for the evaluation of superior glenolabral separation in response to these 3 arthroscopic tests, the findings of this study present displacement magnitudes measured at the biceps anchor under all 3 tests for a range of well-defined lesions. The application of these findings to intraoperative observations during arthroscopic examination is important as they may assist with the assessment of SLAP lesions and the decision to repair.…”

The Glenoid Labrum

“…None demonstrated the sign with just the biceps anchor detached on its own. Repair in cadaveric models with a single suture at the 12.30 o’clock position eliminated peel‐back test in all specimens [79].…”

Superior Labral Anterior Posterior Repair

“…7,10 The SLAP area is in continuity with the anterior and posterior labrum. 23,24 In addition, a tear of the anterior or posterior labrum from a dislocation can extend into the superior labrum. The classic mechanism to develop a SLAP lesion is force, which either pushes the humeral head over or pulls the humeral head away from the superior labrum.…”