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Updated: Aug 19, 2025

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SLAP Tears: Treatment Algorithm.

Luc M Fortier1, Mariano E Menendez1, Benjamin Kerzner1

  • 1Midwest Orthopaedics at Rush, Chicago, Illinois, U.S.A.

Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association
|December 3, 2022
PubMed
Summary
This summary is machine-generated.

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Superior labrum anterior to posterior (SLAP) lesions are common in overhead athletes. Nonoperative management is typically tried first, but biceps tenodesis is increasingly favored over arthroscopic repair due to better outcomes.

Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Shoulder Arthroscopy

Background:

  • Superior labrum anterior to posterior (SLAP) lesions are a frequent cause of shoulder pain, particularly in overhead athletes.
  • Repetitive overhead activities are the primary cause of SLAP lesions, presenting diagnostic and treatment challenges.

Purpose of the Study:

  • To review the diagnostic and treatment challenges of SLAP lesions.
  • To compare nonoperative management, arthroscopic repair, and biceps tenodesis for SLAP lesions in athletes.

Main Methods:

  • Review of current literature on SLAP lesion management.
  • Discussion of factors influencing treatment decisions (age, activity level, symptoms).
  • Comparison of outcomes for conservative treatment, arthroscopic repair, and biceps tenodesis.

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Main Results:

  • Nonoperative management, including physical therapy, is the first-line treatment for many young athletes.
  • Approximately 40% of professional baseball players return to play after nonoperative treatment alone.
  • Biceps tenodesis is gaining popularity as an initial procedure due to higher success rates compared to arthroscopic repair, even in younger athletes.

Conclusions:

  • Treatment choice for SLAP lesions depends on individual factors like age, sport, and symptom severity.
  • While arthroscopic repair is an option for young elite athletes, biceps tenodesis shows promising functional outcomes and return-to-sport rates, becoming a preferred initial treatment.
  • The high failure rate of SLAP repairs is leading to increased consideration of biceps tenodesis as a primary intervention.