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Clinical Orthopaedics and Related Research®

, Volume 469, Issue 4, pp 1056–1060 | Cite as

Greater Strength Increase with Cyst Decompression and SLAP Repair than SLAP Repair Alone

  • Gita Pillai
  • Jason R. Baynes
  • James Gladstone
  • Evan L. Flatow
Symposium: Controversies in Orthopaedics

Abstract

Background

Treatment of symptomatic spinoglenoid cysts has been controversial with options ranging from observation, to open excision, to arthroscopic decompression with or without labral repair. It has recently been suggested that isolated repair of SLAP lesions without cyst decompression can restore function in patients with spinoglenoid cysts and SLAP lesions.

Questions/purposes

We examined gains in external rotation strength after isolated SLAP repair versus SLAP repair and cyst decompression to ascertain if gains in external rotation strength are attributable to SLAP repair or cyst decompression.

Methods

We retrospectively reviewed external rotation strength of 12 patients: six with spinoglenoid cysts and Type II SLAP lesions who underwent arthroscopic SLAP repair and spinoglenoid cyst decompression and six with isolated SLAP lesions who underwent repair of the lesions. Preoperative and postoperative external rotation strength was evaluated using a digitally calibrated dynamometer on the operative and nonoperative sides. The minimum followup was 12 months (mean, 15.2 months; range, 12–27 months).

Results

All of the patients in both cohorts had preoperative external rotation weakness on physical examination and dynamometer testing. The average increase in external rotation strength in the group of patients with SLAP lesions and paralabral cysts was 40% of the contralateral side versus 10% for the cohort with isolated SLAP repairs.

Conclusions

Decompression of paralabral cysts and SLAP repair in patients with preoperative external rotation weakness resulted in greater strength improvement than in patients with isolated SLAP repairs without complications of suprascapular neuropathy. This suggests that gains in external rotation strength are likely mostly attributable to cyst decompression, questioning isolated SLAP repair in the treatment of patients who have primarily weakness with spinoglenoid cysts.

Level of Evidence

Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

Keywords

Rotator Cuff Ganglion Cyst Suprascapular Nerve Slap Lesion Labral Repair 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© The Association of Bone and Joint Surgeons® 2010

Authors and Affiliations

  • Gita Pillai
    • 1
  • Jason R. Baynes
    • 2
  • James Gladstone
    • 1
  • Evan L. Flatow
    • 1
  1. 1.Department of Orthopaedic SurgeryLeni & Peter May Department of Orthopaedic Surgery, Mount Sinai School of MedicineNew YorkUSA
  2. 2. Active Joints OrthopaedicsEnglewoodUSA

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