Surgical treatment of isolated type II superior labrum anterior-posterior (SLAP) lesions: repair versus biceps tenodesis

Ek, Eugene T.; Shi, Lewis L.; Tompson, Jeffrey D.; Freehill, Michael T.; Warner, Jon J.P.

doi:10.1016/j.jse.2013.09.030

Cited by 111 publications

(124 citation statements)

References 27 publications

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“…Although more high-powered studies are necessary, the combined analyses of Boileau et al 3 and Provencher et al 15 suggest that active military personnel younger than 36 years would most benefit from an arthroscopic repair, while those older than 36 years benefit most from tenodesis. These recommendations are supported by Ek et al, 5 who reported comparable results between civilian patients undergoing SLAP repair (age <35 years) and those undergoing biceps tenodesis (age >35 years).…”

Section: Discussionmentioning

confidence: 67%

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Superior Labral Anterior-Posterior (SLAP) Tears in the Military

Rossy¹,

Sánchez

Sanchez

et al. 2016

Sports Health

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Context:Given the notable physical demands placed on active members of the military, comprehension of recent trends in management and outcomes of superior labral anterior-posterior (SLAP) tears in this patient population is critical for successful treatment.Evidence Acquisition:Electronic databases, including PubMed, MEDLINE, and Embase, were reviewed for the years 1985 through 2016.Study Design:Database review.Level of Evidence:Level 5.Results:Active members of the military are at increased risk of sustaining shoulder injuries, particularly SLAP tears. Recent trends in management of SLAP lesions have shifted toward operative intervention. In the correct patient population, repairs of superior labrum tears demonstrate improved function and pain. Surgical repair of SLAP tears, especially in young and active military personnel, is supported.Conclusion:Military personnel are at greater risk of suffering a SLAP tear in comparison with their civilian counterparts. Surgical repair of these lesions is advocated in this subpopulation when the patient is younger than approximately 36 years of age, and if older, biceps tenodesis is likely superior.

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Section: Discussionmentioning

confidence: 67%

“…Given that the biceps anchor may act as a secondary stabilizer of the shoulder, 16,18 surgical repair of these lesions, especially in young patients (<36 years), is supported. 5,15 Further work is necessary to determine the optimal treatment of older members of the armed forces with SLAP lesions.…”

Section: Discussionmentioning

confidence: 99%

Superior Labral Anterior-Posterior (SLAP) Tears in the Military

Rossy¹,

Sánchez

Sanchez

et al. 2016

Sports Health

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“…The incidence of complications was not significantly different when comparing patients treated using knotted anchors in the lateral decubitus position (10%; 11/ 114) 24,27,33 versus the beach-chair position (18%; 6/34) (P ¼ .22). 14,29 No significant difference in complications was appreciated based on the utilization of a trans-rotator cuff portal (8%; 4/51) 27,40 versus a rotator interval portal (18%; 6/34) (P ¼ .19). 14,29 Return to full activity after surgery was reported in 53% (57/107) of patients treated using knotted anchors, 5,14,24,27,29,40 while the number of athletes returning to full activity following knotless repair was only explicitly reported in a single study, occurring in 45% (9/20) of patients 16,28,40 (Table 3).…”

Section: Resultsmentioning

confidence: 97%

“…The dominant arm underwent repair in 80% (107/133) of patients, while arm dominance was not reported in 5 studies. 16,24,27,28,29 Additionally, 76% (179/234) of patients were treated using a knotted suture anchor, 5,14,24,27,29,33,35,40 while 24% Full-text articles assessed for eligibility (n = 38)…”

Section: Resultsmentioning

confidence: 99%

Complications and Return to Activity After Arthroscopic Repair of Isolated Type II SLAP Lesions: A Systematic Review Comparing Knotted Versus Knotless Suture Anchors

Knapik

Kolaczko

Gillespie

et al. 2020

Orthopaedic Journal of Sports Medicine

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Background: Superior labral anterior to posterior (SLAP) tears are one of the most common injuries to the shoulder, with the type II variant representing the most frequently encountered subtype. Purpose: To systematically review the literature to better understand outcomes after arthroscopic repair of isolated type II SLAP lesions using knotted versus knotless anchors based on implant number, implant location, patient position, and portal position. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review investigating all studies in the literature between January 2000 and June 2019 reporting on patients undergoing arthroscopic repair for isolated type II SLAP lesions using knotted versus knotless suture anchors was performed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines using the PubMed, BIOSIS Previews, SPORTDiscus, PEDro, and Embase databases. Results: A total of 234 patients undergoing isolated arthroscopic repair of type II SLAP lesions using suture anchors were identified, with 76% (179/234) treated using knotted anchors versus 24% (55/234) treated using knotless anchors. Complications were reported in 12% of patients treated using knotted anchors versus no patients treated using knotless anchors ( P = .008). The incidence of complications for knotted anchor repair was not significantly affected by patient position ( P = .22) or portal position ( P = .19). Using multiple regression analysis, we found no significant association with the incidence of complications when analyzing for anchor design ( R 2 = 0.02; P = .06) or anchor position ( R 2 = 0.02; P = .92). No significant difference in return-to-activity timing was appreciated based on anchor type ( P = .28), patient position ( P = .98), or portal position ( P = .97) in patients treated using knotted anchors. Conclusion: Patients treated using knotted anchors were significantly more likely to experience a postoperative complication compared with patients treated using knotless anchors after arthroscopic repair of isolated type II SLAP lesions. Despite the increased incidence of a postoperative complication after knotted anchor fixation compared with knotless anchor fixation, multiple regression analysis showed that anchor design and anchor position were not significantly predictive of the incidence of complications. Given the increasing popularity of knotless anchor fixation, further study on the long-term outcomes after knotless repair for isolated type II SLAP lesions is warranted.

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“…E valuation and management of SLAP tears is one of the most controversial topics in arthroscopic surgery. [1][2][3][4][5] Thus, the review published by Kibler and Sciascia, from Lexington, Kentucky, attempts to tackle a challenging issue by performing a high-quality systematic review and generate a consensus statement for the surgical treatment of SLAP tears. 6 Kibler and Sciascia already set the stage for the current investigation in another recent systematic review published in Arthroscopy that scrutinized the 4 diagnostic areas of evaluation for SLAP lesions: (1) history, (2) physical examination, (3) imaging, and (4) diagnostic arthroscopy.…”

Section: See Related Article On Page 669mentioning

confidence: 99%

Editorial Commentary: On Kibler & Sciascia: What Did the Five Fingers Say to the Face? SLAP. A Systematic Review Wake-Up Call to Improve SLAP Repair Guidelines

Harris¹

2016

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Both the quality and quantity of reporting in the SLAP repair literature, especially the surgical indications and technical intraoperative characteristics, leaves significant room for improvement. In their systematic review, Kibler and Sciascia identify this considerable underlying imprecision. Based on the current literature, no consensus exists for establishing any criteria for a successful SLAP repair--surgical indications, characteristics (type, location, number of anchors), completeness of repair, or rehabilitation.

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Surgical treatment of isolated type II superior labrum anterior-posterior (SLAP) lesions: repair versus biceps tenodesis

Cited by 111 publications

References 27 publications

Superior Labral Anterior-Posterior (SLAP) Tears in the Military

Superior Labral Anterior-Posterior (SLAP) Tears in the Military

Complications and Return to Activity After Arthroscopic Repair of Isolated Type II SLAP Lesions: A Systematic Review Comparing Knotted Versus Knotless Suture Anchors

Editorial Commentary: On Kibler & Sciascia: What Did the Five Fingers Say to the Face? SLAP. A Systematic Review Wake-Up Call to Improve SLAP Repair Guidelines

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