Unstable isolated SLAP lesion: clinical presentation and outcome of arthroscopic fixation

Abstract

Purpose: The purpose of this study was to describe the clinical presentation and sensitivity of testing of unstable isolated SLAP (superior labrum anterior posterior) lesions and to evaluate the efficacy of arthroscopic treatment.

Type of study: Case series.

Methods: A retrospective review was made of 44 unstable SLAP lesions in 41 patients (40 male, 1 female) who did not have other pathologic shoulder findings. The mean follow-up period was 33 months (range, 25 to 67 months) and the mean age at the time of surgery was 24 years (range, 17 to 43 years). Twenty-six patients had an injury on the dominant shoulder and 3 had bilateral shoulder involvement. Arthroscopic fixation was performed with the use of a biodegradable tack (Suretac; Acufex, Mansfield, MA) in 14 cases, and with a screw-type metallic suture anchor (mini-Revo; Linvatec, Largo, FL) in 30 cases.

Results: Pain (100%) and clicking (57%) were the most common symptoms. The compression-rotation test was positive in 84% of the patients before surgery. The average UCLA score at the last follow-up was 32.3 points; 22 cases were graded excellent, 16 good, and 6 poor. Based on the postoperative performance data collected from 33 athletes, 25 of them (76%) were able to return to their athletic activities. Among them, throwing athletes showed statistically better performance than did nonthrowing athletes (P = .011).

Conclusions: Pain, followed by clicking, was the most common symptom, and the most common sign was a positive compression rotation test. Arthroscopic treatment of unstable isolated SLAP lesions resulted in good or excellent UCLA scores in 86% of the patients. Throwing athletes showed more satisfactory results than nonthrowing athletes.

Level of evidence: Type IV, case series with no, or historical, control group.