SLAP tear and shoulder arthroscopic repair
SLAP is an acronym for superior labrum anterior to posterior tears – this refers to the location and direction of the injury. It happens when the labrum – the ring of cartilage which surrounds the shoulder socket – is torn across the top, extending from the front (anterior to the back (posterior) side of the shoulder.
SLAP tears are often seen in younger patients, particularly in those who engage in repetitive overhead motions with frequency. Activities such as lifting weights and bowling overarm can contribute to SLAP tears, as well as sudden falls onto an outstretched arm. They may also develop from general wear-and-tear, particularly in patients over age 40.
Treatments for SLAP tear
Rest and activity modification are generally the first course of treatment. Pain may be managed using over the counter non-steroidal anti-inflammatory medications (NSAIDS). In some cases, corticosteroid injections are employed to reduce ongoing pain or to diagnose a tear.
Physiotherapy may then be initiated to increase strength in the rotator cuff, scapular stabiliser, and deltoid muscle. This helps to stabilise the joint and reduce ongoing pain in many individuals.
If conservative measures prove unsuccessful at reducing pain, surgery to repair the glenoid labrum may be considered. Most surgical approaches to SLAP repair are conducted via arthroscopy, allowing the surgeon to repair the injury with minimal disruption to the surrounding tissues.
SLAP repair surgery
Surgical treatments for SLAP tears are based on their classification. Different approaches are recommended depending on the tear’s classification and location.
Treatment for most types of tears involves debridement. This involves shaving away the damaged edges of the labrum which cause irritation and pain, leaving a smooth surface. Type I tears (caused by general wear and tear) and type III tears (larger tears with an intact anchor to the biceps) can generally be treated with debridement alone.
Type II and IV tears are characterised by an unstable biceps anchor and usually require more extensive surgery to reattach the labrum to the glenoid rim. This may be combined with debridement, and may be combined with surgery to repair the biceps tendon (biceps tenodesis).
Indications for SLAP tear repair surgery
SLAP repair surgery is considered appropriate in cases which do not respond to conservative management. Surgery may be considered earlier if the SLAP tear occurs alongside another injury, such as a Bankart tear or shoulder dislocation.
As with any case, Dr Jonathan Cabot approaches SLAP repair on an individual basis. Any treatments – surgical or otherwise – will be discussed and assessed for suitability at your consultation appointment.
Recovery from SLAP repair surgery
You may discontinue us of the sling as pain permits, generally 4-6 weeks after the procedure. Physiotherapy to train the rotator cuff, scapular stabiliser, and deltoid muscle is commenced within this period.
Most patients regain a normal range of movement within 6 weeks and return to normal strength levels after 10 weeks. Sports and other intensive activities may be gradually introduced from 6 months following the procedure.