Advertisement

Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 16, Issue 12, pp 1151–1157 | Cite as

Arthroscopic repair of isolated type II superior labrum anterior–posterior lesion

  • Patrick Shu-Hang Yung
  • Daniel Tik-Pui Fong
  • Ming-Fat Kong
  • Chun-Kong Lo
  • Kwai-Yau Fung
  • Eric Po-Yan Ho
  • Derwin King-Chung Chan
  • Kai-Ming Chan
Shoulder

Abstract

The effectiveness of arthroscopic repair of type II superior labrum anterior–posterior lesion (SLAP) was unclear as previous studies examined this treatment with patients of combined types of SLAP lesions. To address this research gap, we evaluated the clinical and functional outcomes of arthroscopic repair for 16 patients (mean = 24.2, SD = 6.5) with clinical evidence of isolated type II SLAP lesion. After having arthroscopic stabilizations with Bioknotless suture anchors (Mitek), the patients were offered post-operative rehabilitation programs (e.g., physiotherapy) for 6 months. The symptoms of SLAP lesion and the functions of the shoulder were assessed pre-operatively and 28-month post-operatively by O’Brien test, Speed test, Yergason test, and University of California at Los Angeles rating for pain and function of the shoulder. Wilcoxon Signed Ranks test and McNemar test were employed to analyze the difference between assessment in pre-operation and post-operation phases. The result showed that patients’ shoulder functions improved (UCLA Shoulder Score), and symptoms of SLAP lesion reduced (O’Brien test, Speed test, and Yergason test) significantly (P < 0.05). Time for returning to play with pre-injury level was in average 9.4 months (range 4–24), and no complication or recurrence was detected. We concluded that arthroscopic repair is an effective operation of type II SLAP lesion with good clinical and functional outcomes; however, athletes with high demand of overhead throwing activities are likely to take longer duration of rehabilitation to attain full recovery.

Keywords

Shoulder SLAP Sports medicine Arthroscopy Surgery 

References

  1. 1.
    Altchek DW, Warren RF, Wickiewicz TL (1992) Arthroscopic labral debridement. A three-year follow-up study American. J Sports Med 20(6):702–706CrossRefGoogle Scholar
  2. 2.
    Andrews JR, Carson WG Jr, McLeod WD (1985) Glenoid labrum tears related to the long head of the biceps. Am J Sports Med 13(5):337–341PubMedCrossRefGoogle Scholar
  3. 3.
    Burkart A, Imhoff AB, Roscher E (2000) Foreign-body reaction to the bioabsorbable suretac device. Arthroscopy 16(1):91–95PubMedGoogle Scholar
  4. 4.
    Burkhart SS, Morgan CD, Kibler WB (2000) Shoulder injuries in overhead athletes. The “dead arm” revisited clinics in sports. Medicine 19(1):125–158Google Scholar
  5. 5.
    Burkhart SS, Morgan CD, Kibler WB (2000) The disable throwing shoulder: spectrum of pathology part I: Pathoanatomy and biomechanics. Arthroscopy 19(4):404–420Google Scholar
  6. 6.
    Cordasco FA, Steinmann S, Flatow EL (1993) Arthroscopic treatment of glenoid labral tears. Am J Sports Med 21(3):425–431PubMedCrossRefGoogle Scholar
  7. 7.
    Ellman H, Hanker G, Bayer M (1986) Repair of the rotator cuff. End-result study of factors influencing reconstruction. J Bone Joint Surg Am 68(8):1136–1144PubMedGoogle Scholar
  8. 8.
    Field LD, Savoie FH 3rd (1993) Arthroscopic suture repair of superior labral detachment lesions of the shoulder. Am J Sports Med 21(6):783–790 discussion 790PubMedCrossRefGoogle Scholar
  9. 9.
    Gilecreest EL, Albi P (1939) Unusual lesions of muscles and tendons of the shoulder girdle and upper arm. Surg Gynecol Obstet 68:903–917Google Scholar
  10. 10.
    Holtby R, Razmjou H (2004) Accuracy of the speed’s and Yergason’s tests in detecting biceps pathology and SLAP lesions: comparison with arthroscopic findings. J Arthrosc Relat Surg 20(3):231–236CrossRefGoogle Scholar
  11. 11.
    Kim SH, Ha KI, Kim SH et al (2002) Results of arthroscopic treatment of superior labral lesions. J Bone Joint Surg Am 84-A(6):981–985PubMedGoogle Scholar
  12. 12.
    Law BKY, Yung PSH, Ho PY, Chang JJ, Chan KM (2008) The surgical outcome of immediate arthroscopic Bankart repair for first time anterior shoulder dislocation in young active patients. Knee Surg Sports Traumatol Arthrosc 16:188–193PubMedCrossRefGoogle Scholar
  13. 13.
    Maffet MW, Gartsman GM, Moseley B (1995) Superior labrum-biceps tendon complex lesions of the shoulder. Am J Sports Med 23(1):93–98PubMedCrossRefGoogle Scholar
  14. 14.
    Mohana-Borges AVR, Chung CB, Resnick D (2003) Superior labral anteroposterior tear: classification and diagnosis on MRI and MR arthrography. Am J Roentgenol 181:1449–1462Google Scholar
  15. 15.
    Morgan CD, Burkhart SS, Palmeri M, Gillespie M (1998) Type II SLAP lesions: three subtypes and their relationships to superior instability and rotator cuff tears. Arthroscopy 14:553–565PubMedGoogle Scholar
  16. 16.
    O’Brien SJ, Allen AA, Coleman SH (2002) The trans-rotator cuff approach to SLAP lesions: technical aspects for repair and a clinical follow-up of 31 patients at a minimum of 2 years. Arthroscopy 18(4):372–377PubMedGoogle Scholar
  17. 17.
    Resch H, Golser K, Theoni H (1993) Arthroscopic repair of superior glenoid labral detachment (the SLAP lesion). J Shoulder Elbow Surg 2(3):147–155CrossRefGoogle Scholar
  18. 18.
    Resnick D (1997) Shoulder. In: Resnick D, Kang HS (eds) Internal derangements of joints: emphasis on MR imaging. Saunders, Philadelphia, pp 71–281Google Scholar
  19. 19.
    Rhee YG, Lee DH, Lim CT (2005) Unstable isolated SLAP lesion: clinical presentation and outcome of arthroscopic fixation. Arthroscopy 21(9):1099PubMedGoogle Scholar
  20. 20.
    Segmuller HE, Hayes MG, Saies AD (1997) Arthroscopic repair of glenolabral injuries with an absorbable fixation device. J Shoulder Elbow Surg 6(4):383–392PubMedCrossRefGoogle Scholar
  21. 21.
    Snyder SJ, Banas MP, Karzel RP (1995) An analysis of 140 injuries to the superior glenoid labrum. J Shoulder Elbow Surg 4(4):243–248PubMedCrossRefGoogle Scholar
  22. 22.
    Snyder SJ, Karzel RP, Del Pizzo W (1990) SLAP lesions of the shoulder. Arthroscopy 6(4):274–279PubMedGoogle Scholar
  23. 23.
    Speer KP, Warren RF, Pagnani M (1996) An arthroscopic technique for anterior stabilization of the shoulder with a bioabsorbable tack. J Bone Joint Surg Am 78(12):1801–1807PubMedGoogle Scholar
  24. 24.
    Thal R (2001) A Knotless Suture Anchor: technique for use in arthroscopic Bankart repair. Arthroscopy 17(2):213–218PubMedCrossRefGoogle Scholar
  25. 25.
    Warner JJ, Kann S, Marks P (1994) Arthroscopic repair of combined Bankart and superior labral detachment anterior and posterior lesions: technique and preliminary results. Arthroscopy 10(4):383–391PubMedGoogle Scholar
  26. 26.
    Yergason RM (1931) Supination sign. J Bone Joint Surg 13:160Google Scholar
  27. 27.
    Yoneda M, Hirooka A, Saito S (1991) Arthroscopic stapling for detached superior glenoid labrum. J Bone Joint Surg Br 73(5):746–750PubMedGoogle Scholar
  28. 28.
    Zuckerman JD, Matsen FA 3rd (1984) Complications about the glenohumeral joint related to the use of screws and staples. J Bone Joint Surg Am 66(2):175–180PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Patrick Shu-Hang Yung
    • 1
    • 2
    • 3
  • Daniel Tik-Pui Fong
    • 2
    • 3
  • Ming-Fat Kong
    • 1
  • Chun-Kong Lo
    • 1
  • Kwai-Yau Fung
    • 1
    • 2
  • Eric Po-Yan Ho
    • 2
  • Derwin King-Chung Chan
    • 2
  • Kai-Ming Chan
    • 2
    • 3
  1. 1.Department of Orthopaedics and TraumatologyAlice Ho Miu Ling Nethersole HospitalHong KongChina
  2. 2.Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Faculty of MedicineThe Chinese University of Hong KongHong KongChina
  3. 3.The Hong Kong Jockey Club Sports Medicine and Health Sciences Centre, Faculty of MedicineThe Chinese University of Hong KongHong KongChina

Personalised recommendations