Return to Play After Type II Superior Labral Anterior-Posterior Lesion Repairs in Athletes: A Systematic Review

Abstract

Background Superior labral anterior-posterior (SLAP) lesions are a common cause of pain and disability in athletes. Individual studies have suggested low patient satisfaction with SLAP repairs in throwing athletes in particular and it is unclear how frequently athletes return to their previous level of competetion. Questions/purposes We systematically reviewed the literature to determine (1) patient satisfaction and (2) return to play at previous level of competition among throwing athletes compared to all athletes who underwent repair of Type II SLAP tears using various types of fixation. Methods We searched databases for English-language articles in peer-reviewed journals from 1950 to 2010 reporting Type II SLAP repairs with 2-year followup for our systematic review. A total of 506 patients with Type II SLAP tears were reviewed from 14 studies; of these, 327 had SLAP lesions repaired by anchor, 169 by tacks, and 10 by staples. Of the 506 patients, 198 were overhead athletes with a pooled subset of 81 identified baseball players. Results For the entire patient population, 83% had ''good-to-excellent'' patient satisfaction and 73% returned to their previous level of play whereas only 63% of overhead athletes returned to their previous level of play. Anchor repair in overhead athletes resulted in a higher percentage of ''good-to-excellent'' patient satisfaction (88% versus 74%) and a slightly higher return to play rate (63% versus 57%) compared with tack repair. Conclusions Repair of Type II SLAP tears leads to a return to previous level of play in most patients. Overhead athletes appear to have a lower rate of return to level of previous of play. Anchor fixation appears to be the most favorable fixation in both subjective scores and return to previous level of play.

Blood supply and vascularity of the glenoid labrum: Its clinical implications

“…The current study has shown that the glenoid labrum has a rich blood supply, which supports the excellent outcomes of glenoid labrum healing and joint re-instability observed, regardless of the types of the glenoid labrum lesions or their management. [33][34][35][36][37]10 It is suggested that the blood supply to the glenoid labrum is thus sufficient to enable its reattachment. On the other hand, it could be questioned how and why incomplete or non-healing of labrum injuries occurs, leading to recurrent shoulder instability and poor blood supply to the glenoid labrum, such as in diabetic patients, which could impair healing of the glenoid labrum.…”

“…Several studies [3][4][5][6][7][8][9][10][11] have reported a significant correlation between labral fixation and glenohumeral translation. In contrast, Kim et al 12 reported an insignificant correlation between the extent of the labral lesion and the frequency of glenohumeral dislocation.…”

Return to Play of Elite Overhead Athletes with Superior Labral Anterior Posterior Tears only after Rehabilitation

“…Similarly, Brockmeier et al 5) reported a mean ASES score of 92.6 in an athletic population in which only 74% returned to their pre-injury level. Recently, Sayde et al 28) performed a systematic review of 14 studies regarding the repair of type II SLAP tears in athletes. They found that for all athletes, 73% were able to return to their previous level of play, whereas only 63% of overhead athletes returned to their previous level of play.…”

SLAP Lesions Part III: Return to Play After SLAP Repair

“…They concluded that most athletes have good to excellent results (83 %), and overall, 73 % of the patients were able to return to their previous level of play. Upon further subanalysis, only 63 % of overhead athletes returned to their previous level of play [ 5 ].…”

“…A certain subset of patients may benefi t from surgical repair of SLAP tears. Athletes, and in particular overhead athletes who participate in baseball, tennis, handball, badminton, softball, swimming, volleyball, and squash among others, may have variable levels of satisfaction after SLAP repair [ 5 ].…”