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A Treatment-Based Algorithm for the Management of Type-II SLAP Tears
Adam M Johannsen1, John G Costouros1
1Department of Orthopaedic Surgery, Stanford University, Stanford, CA, USA.
For Type-II superior labral tears (SLAP), surgical management offers good outcomes. Biceps tenodesis may be superior to SLAP repair for patients over 40, providing better pain relief and function.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Shoulder Arthroscopy
Background:
- Type-II superior labral tears (SLAP) management is debated, with options including non-operative care, SLAP repair, biceps tenotomy, and biceps tenodesis.
- A universally accepted treatment algorithm for SLAP tears is lacking.
Purpose of the Study:
- To establish a treatment algorithm for Type-II SLAP tears.
- To base recommendations on current literature and expert consensus.
Main Methods:
- Comprehensive literature review.
- Incorporation of expert opinions.
- Development of a patient-specific treatment protocol considering age, activity level, and pathology.
Main Results:
- Surgical management of Type-II SLAP tears demonstrates good to excellent outcomes when indications are precise.
- Biceps tenodesis may offer superior pain relief and functional improvement compared to SLAP repair in patients aged 40 and above.
Conclusions:
- Following failed non-operative treatment, surgical intervention for Type-II SLAP tears generally yields favorable results.
- SLAP repair is recommended for patients under 40 without proximal biceps issues; biceps tenodesis is advised for those over 40 or with significant biceps pathology.
- Biceps tenotomy is best suited for elderly or low-demand individuals.
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