Presentation
Patient Symptoms Patients presenting with a SLAP lesion typically have several very similar complaints that led to them seeking medical attention. [medbridgeeducation.com]
Out of the 71 patients evaluated, 68 (96%) presented associated lesions, and only three cases (4%) presented a SLAP lesion alone. [scielo.br]
For example, the majority of overhead athletes present with posterosuperior lesions while individuals who have traumatic SLAP lesions typically present with anterosuperior lesions. [mikereinold.com]
If the two are present, then they are both repaired during the same procedure. [orlincohen.com]
Very little evidence about non-operative treatment for type II SLAP lesions was available when the present study was designed. [bjsm.bmj.com]
Entire Body System
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Plethora
Despite the plethora of literature regarding SLAP lesions, their clinical diagnosis remains challenging for a number of reasons. [ncbi.nlm.nih.gov]
Respiratoric
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Sore Throat
Since it is not a full length tube, there is no sore throat. Surgery is performed in the lateral position. This means that you will be placed on your side. The operation is performed arthroscopically through 3 small “portals” (5 mm incisions). [orlandparkorthopedics.com]
Musculoskeletal
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Tendon Disorder
disorders and SLAP lesions. [42] When conservative treatment fails, a surgical approach is in order. [3] After surgery, for 3 to 4 weeks, the shoulder of the patient is placed in a sling, which immobilises the shoulder in internal rotation and leads [physio-pedia.com]
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Long Arm
arm of the biceps inserts directly into the superior labrum, which also provides stabilisation to the superior part of the joint. [4] [6] In addition, the rotator_Cuff muscles are essential to ensure dynamic shoulder stability as they prevent excessive [physio-pedia.com]
Psychiatrical
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Distractibility
Originally, Andrews et al theorized that eccentric load to the biceps during throw deceleration resulted in a tension-distraction traumatic or repetitive injury to the biceps-labral complex. [medbridgeeducation.com]
Neurologic
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Cervical Radiculopathy
Potential differential diagnostic considerations include A/C joint degeneration, strain or pathology, biceps tendinopathy, cervical radiculopathy, brachial plexus injury, fracture, Bankart lesion, dislocation, glenohumeral degeneration, instability, and [ilchiro.org]
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Radiculopathy
Potential differential diagnostic considerations include A/C joint degeneration, strain or pathology, biceps tendinopathy, cervical radiculopathy, brachial plexus injury, fracture, Bankart lesion, dislocation, glenohumeral degeneration, instability, and [ilchiro.org]
Workup
MRI is typically included in the initial workup for patients with suspected labral pathology. (42) The incorporation of gadolinium-enhanced MR arthrography provides the highest sensitivity (82-96%) and specificity (91-98%) for detecting SLAP lesions. [ilchiro.org]
Treatment
Treatment 3 months of physical therapy focusing on strengthening the dynamic stabilizers. If non-op treatment fails to eliminate symptoms arthroscopic biceps tenotomy with or without Biceps Tenodesis is indicated. [eorif.com]
Anti-inflammatory treatment is advised to reduce local inflammation resulting from the injury. [pathologies.lexmedicus.com.au]
Conservative, non-surgical, treatment is always preferable if those treatments are effective and successful in actually resolving a complaint. [academyofclinicalmassage.com]
A review of treatments, which will work and when. [caringmedical.com]
Controversies about treatment The initial treatment for a patient with what might be considered to be a SLAP lesion is non-operative treatment. [ncbi.nlm.nih.gov]
Prognosis
Treatment and prognosis type I tears are usually asymptomatic and do not require treatment type II tears require surgical reattachment type III tears usually require resection of the bucket handle tear 2 sublabral sulcus : SLAP type II tears can appear [radiopaedia.org]
Poor outcomes after SLAP repair: descriptive analysis and prognosis. Arthroscopy. 2009;25(8):849-55. [ Links ] 27. Voos JE, Pearle AD, Mattern CJ, Cordasco FA, Allen AA, Warren RF. Outcomes of combined arthroscopic rotator cuff and labral repair. [scielo.br]
Prognosis Initial reports suggested good results with arthroscopic superior labral repairs with a high success both in nonthrowing and throwing athletes, as well as a high rate of overhead athletes returning to their preinjury level of activity. [19, [emedicine.medscape.com]
Poor outcomes after SLAP repair: descriptive analysis and prognosis. Arthroscopy. 2009 Aug; 25(8): 849-55. [ Links ] 28. Oh JH, Kim SH, Lee HK, Jo KH, Bae KJ. [scielo.org.za]
ALPSA lesions are more complex and have a worse prognosis than Bankart lesions; their chronic nature, in combination with a twofold higher bone loss during surgery compared with anterior instability alone, leads to an arthroscopic failure rate about double [pubs.rsna.org]
Etiology
Etiology In the acute setting they are most frequently seen in falls onto an outstretched arm or in throwing sports athletes. Classification The most widely used system for classification of SLAP tears was originally described by Snyder 7. [radiopaedia.org]
Etiology In considering the etiology of superior labral (labrum) lesions, it is useful to divide them into the the following two broad categories: Compression injuries - These are usually secondary to a fall on an outstretched arm that is in an abducted [emedicine.medscape.com]
[…] its labral anchor – becoming progressively more problematic as the tear progresses. (15) Chronic SLAP lesions do not typically occur in the absence of concurrent shoulder pathology; in fact, only 28% of SLAP tears are isolated problems. (17) Chronic etiologies [ilchiro.org]
Although both authors reported on similar lesions, the etiology remained unclear. [jospt.org]
The etiology of SLAP lesions is uncertain, although the literature describes the following as possible causes: compression forces applied to the glenohumeral joint after a fall with the shoulder in a position of abduction and flexion; and tension forces [scielo.br]
Epidemiology
Definition Superior labrum anterior & posterior Injury to superior part of glenoid labrum involving region of biceps tendon insertion Epidemiology 2 groups 1. [52.62.202.235]
The identification of these normal variants can help to prevent the misdiagnosis of labral lesions. [4] Epidemiology/Aetiology The age of the patient has an impact on the superior labrum. [physio-pedia.com]
Epidemiology Superior labral (labrum) lesions are unusual. The reported prevalence in patients undergoing shoulder arthroscopy has ranged from 3.9% to 6%. [emedicine.medscape.com]
Pathophysiology
The understanding on the pathophysiology behind SLAP lesions has progressed greatly since the advent of arthroscopic shoulder surgery. [sportsinjurybulletin.com]
Aetiology There are several controversies about the pathophysiology of SLAP tears. [ncbi.nlm.nih.gov]
Pathophysiology On a biomechanical level, incompetence of the superior labrum and biceps anchor has been shown to have a deleterious effect on anterior glenohumeral stability. [emedicine.medscape.com]
Prevention
Keeping a strong musculature around the shoulder prevents a SLAP tear Prevention Prevention of SLAP lesions is best achieved with adequate strengthening of the shoulder muscles and shoulder blades to increase the stability of the rotator cuff and, at [pathologies.lexmedicus.com.au]
The best option for the treatment of a SLAP tear is prevention. As there may be an association with poor mechanics, overhead athletes should maintain a stretching program to maintain overall internal rotation of the shoulder. [rchsd.org]
Adequate warm-up before activity and avoidance of high-contact sports will help prevent of an instability-causing injury. [shoulderdoc.co.uk]
The technique used may not be determined until the tear is visible to the surgeon and the repair procedure may include: Debridement of fraying tissue to prevent a tear Securing the loose labrum to the cup of the joint Repair or removing the torn labrum [losalortho.com]
Gentle stretches will improve your range of motion and prevent stiffness in your shoulder. As healing progresses, exercises to strengthen the shoulder muscles and the rotator cuff will gradually be added to your program. [orthoinfo.aaos.org]