Diagnosis and Management of SLAP tears

Question 1

The biceps anchor is located on the __________________

Answer 1

supraglenoid tubercle

Question 2

_______________ covers the superior rim of the glenoid

Answer 2

hyaline cartilage

Question 3

The biceps tendon inserts into the _____________

Answer 3

superior labrum

Question 4

What is a SLAP tear

Answer 4

fraying or detachment of the labral complex at the superior margin of the glenoid

Question 5

Type 1 SLAP tear

Answer 5

fraying and a degenerative appearance of the superior labrum

Question 6

Type 2 SLAP tear

Answer 6

A detachment of the superior labrum from the supraglenoid tubercle

Question 7

Type 3 SLAP tear

Answer 7

a bucket handle tear that displaced into the joint while the biceps root remains stable

Question 8

Type 4 SLAP tear

Answer 8

A bucket handle tear where the tear propagates into the biceps tendon

Question 9

Mechanism of injury for SLAP tears

Answer 9

repetitive throwing, hyperextension, fall on an outstretched hand, heavy lifting, direct trauma, and contracture of the posterior-inferior glenohumeral ligament in throwers

Question 10

Sensitivity and specificity for SLAP tears

Answer 10

over 80%

Question 11

Positive LR for SLAP

Answer 11

greater than 10 generates large and often conclusive shifts in probability

Question 12

Negative LR for SLAP

Answer 12

Less than 0.10 generates large and often conclusive shifts in probability

Question 13

Symptoms of SLAP tear

Answer 13

anterior pain nonspecific location, deep pain, gradual loss of function, difficulty overhead motions, clicking or popping, night pain, weakness, and instability

Question 14

Physical examination components for SLAP tears

Answer 14

GHJ/STJ ROM, symmetry, scapular dyskinesis, strength/stability, clinical tests, pitching kinematics

Question 15

Which special tests have higher sensitivity or specificity

Answer 15

Biceps load 1 and 2, O’brien test, speed’s test, and yergason’s test

Question 16

no ________ can definitively diagnose SLAP lesions

Answer 16

one test

Question 17

What clustered clinical tests are best to rule in SLAP lesions?

Answer 17

Biceps load 1 and 2, and Speed’s test

Question 18

Conservative methods for SLAP tear

Answer 18

Focus on endurance and strength training of the rotator cuff and scapular stabilizer muscles, posterior shoulder stretching/mobilization of capsular and cuff tightness, rest from aggravating activities to decrease inflammation

Question 19

Conservative methods: If therapy does not resolve symptoms:

Answer 19

anti-inflammatory or a corticosteroid injection for relief

Question 20

Indications for surgery

Answer 20

unresponsive to extensive non-operative treatment

Question 21

Which types of SLAP tears often require surgery, especially in athletes?

Answer 21

Type 2 and 4

Question 22

Overhead athletes have less success in returning to overhead activity and prior level of performance after _________________ repair

Answer 22

arthroscopic Type 2 SLAP

Question 23

_____________ durations of rehab are necessary for overhead athletes

Answer 23

longer

Question 24

Overall RTS time frame for Elite overhead athletes

Answer 24

11-13 months

Question 25

Overall RTS time frame for overhead athletes

Answer 25

6-9 months