SLAP Tear

lateral view of shoulderA SLAP tear is an injury to the labrum of the shoulder, specifically at the point where the biceps tendon attaches. SLAP stands for Superior Labrum from Anterior to Posterior. This area is particularly prone to injury as it has a poor vascular supply and therefore limited capacity for repair.

Mechanism of injury

  • Fall onto an outstretched hand
  • Repetitive overhead actions (such as throwing)
  • Lifting a heavy object

Symptoms

  • a catching sensation and pain with shoulder movements, most often overhead activities such as throwing
  • pain deep within the shoulder or at posterior of the shoulder joint
  • If associated with biceps tendonitis, patients may complain of pain over the anterior of the shoulder.

Diagnosis

Alongside physical examination, a contrast MRI with gadolinium injected into the shoulder can often help to identify a SLAP tear. In many cases, a confirmed SLAP tear can only be identified at the time of surgery.

Treatment

  • Initial rest and support of affected limb
  • anti-inflammatory medication
  • injections of cortisone to reduce inflammation in joint
  • Surgery

Types of SLAP surgery

  • Debridement
    • the torn portion of the labrum is shaved away to leave a smooth edge
    • results of surgery can be more predictable and rehabilitation is often not as restrictive as a SLAP repair
    • only suitable for minor tears that do not involve the biceps tendon.
  • SLAP repair
    • an arthroscopic procedure that uses sutures with anchors attached to resecure the torn labrum down to the shoulder socket
    • restores the normal anatomy of the shoulder
    • allows normal function of previously damaged labrum and biceps attachment
    • best suited to patients with an otherwise healthy shoulder who want to remain athletically active
    • rehabilitation most often begins with around 6 weeks of restricted motion as the labrum heals, followed by 3 or 4 months of functional exercise to re-strengthen the joint.
  • Biceps tenodesis
    • the biceps tendon is cut from where it attaches to the labrum, and is reinserted into another area
    • this decreases the forces that pull on the SLAP region, alleviating symptoms
    • most often performed on patients over 40 years of age or patients with associated biceps tendonitis or tearing.

Find out more at: http://orthopedics.about.com/cs/generalshoulder/a/slap.htm

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