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SLAP lesions: a treatment algorithm.

Matthias Brockmeyer1, Marc Tompkins2,3, Dieter M Kohn1

  • 1Department of Orthopedic Surgery, Saarland University, Kirrberger Str., 66421, Homburg/Saar, Germany.

Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA
|January 29, 2016
PubMed
Summary
This summary is machine-generated.

Superior labrum anterior to posterior (SLAP) lesions impair shoulder function, especially in athletes. This article proposes a treatment algorithm considering lesion type, patient age, and activity level for optimal outcomes.

Keywords:
Biceps tendonSLAP lesionShoulderSuperior labrumTreatment algorithm

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Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Shoulder Arthroscopy

Background:

  • Superior labrum anterior to posterior (SLAP) tears are common in athletes and can significantly impact shoulder function.
  • Arthroscopic repair of SLAP lesions is successful in young athletes but yields mixed results in throwing athletes and older populations.
  • Biceps tenotomy or tenodesis is a viable alternative for middle-aged and older patients with SLAP lesions.

Purpose of the Study:

  • To introduce a treatment algorithm for SLAP lesions based on current literature and clinical experience.
  • To guide treatment decisions by considering lesion type, patient demographics, and functional demands.
  • To differentiate true SLAP lesions from normal variations and degenerative changes to prevent overtreatment.

Main Methods:

  • Literature review of SLAP lesion treatments.
  • Analysis of clinical experience with SLAP lesion management.
  • Development of a tiered treatment algorithm based on lesion classification (Type I-VII).

Main Results:

  • The algorithm stratifies treatment based on SLAP lesion type, age, concomitant injuries, and patient activity level.
  • Type I: Conservative treatment or debridement. Type II: Repair or tenotomy/tenodesis.
  • Type III: Resection; Type IV: Repair with potential tenotomy/tenodesis; Type V-VII: Combined repairs.

Conclusions:

  • A tailored treatment algorithm is crucial for optimizing outcomes in SLAP lesions.
  • Distinguishing true SLAP lesions from degenerative changes is key to successful management.
  • The proposed algorithm provides a structured approach to SLAP lesion treatment, considering individual patient factors.