Abstract
SLAP lesions were first classified by Snyder in 1990. Results of treatment have been controversial without clear consensus. All have agreed that prospective studies would be useful. We conducted such a study between 2008 to 2114 that randomized treatment between sham surgery, biceps tenodesis and labral repair. No significant differences in results between the groups were found. Crossover between groups was only possible from the sham surgery group and this may introduce some degree of bias. However, the six month outcomes between all three groups before any crossover were statistically identical. Our results also do not favor biceps tenodesis versus SLAP repair when surgery is performed. Based on these results we have narrowed our indications for SLAP lesion surgery. We still treat some SLAP lesions surgically and individualize our treatment in each such cases. Most SLAP lesion patients, however, are ultimately treated non-operatively.
Highlights
Discussion of the clinical importance and treatment of type II SLAP lesions has a history spanning more than 25 years
A review by Huri et al [3] in 2014 concludes that the evaluation and treatment of SLAP lesions continues to be controversial. They state that the results after repair have been shown to be less successful than initially reported, and that dissatisfaction with the results has led to an increased use of biceps tenotomy or tenodesis as the initial treatment, especially in older individuals
They conclude that the role of biceps tenodesis or tenotomy in the overhead athlete is controversial, and that the use of SLAP repair in this population remains uncertain
Summary
Discussion of the clinical importance and treatment of type II SLAP lesions has a history spanning more than 25 years. A review by Huri et al [3] in 2014 concludes that the evaluation and treatment of SLAP lesions continues to be controversial They state that the results after repair have been shown to be less successful than initially reported, and that dissatisfaction with the results has led to an increased use of biceps tenotomy or tenodesis as the initial treatment, especially in older individuals. We stated that to obtain Level I or II evidence, randomized studies designed to compare SLAP repair, biceps tenodesis and non-operative treatment were needed Based on this background, we conducted a clinical trial [6] from 2008 to 2014, in which 118 patients with a mean age of 40 years were randomized to labral repair, biceps tenodesis or sham (placebo) surgery. The patients, the treating physiotherapists/manual therapists and the person collecting and analyzing the data were blinded to the study group assignment
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