SLAP Lesion

Question 1

What is a SLAP lesion?

Answer 1

Superior labral anterior to posterior tear

Question 2

What does the labrum do?

Answer 2

Deepens the glenoid by 50% and thus stabalizes the shoulder joint

Question 3

What causes SLAP lesions?

Answer 3

Traumatic event (fall of outstretched arm)
Degenerative inature

Question 4

What’s the treatment for SLAP lesions?

Answer 4

Conservative: rest, ice, NSAIDs, PT

Surgery: arthroscopic

• degenerative but stable labrums are trimmed to preserve healthy remaining labrum, recovery 6w
• detached labrums require repair if pt is young enough (tissue is healthy to work with), otherwise biceps tenodesis is performed, sling or 6 weeks and recovery after 6 months

Question 5

What are the classifications of SLAP tears?

Answer 5

Type 1: partial tear and degen of sup labrum, labrum not completely detached
- tx: debride edges

Type 2: most common, sup labrum is completely torn off the glenoid due to an injury (often shoulder dislocation), ant vs post
- tx: SLAP repair

Type 3: bucket-handle tear of the labrum, labrum haning causes locking, popping, or clunking
- tx: SLAP repair

Type 4: tear of the labrum extends into the long head of biceps tendon
- tx: SLAP repair or biceps tenodesis

Question 6

What are the disadvantages to a biceps tenotomy?

Answer 6

Lose supination strength, cosmetic issue with bunched up biceps muscle, cramping (10% of cases)

Last resort type surgery