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Failure Rates of SLAP Repair Compared With Subpectoral Biceps Tenodesis for Young Military Patients With Type 2 SLAP
John P Scanaliato1,2, Alexis B Sandler1,2, Bassem Darwish3
1William Beaumont Army Medical Center, El Paso, Texas, USA.
The American Journal of Sports Medicine
|March 21, 2026
Summary
Biceps tenodesis demonstrates superior long-term outcomes compared to superior labrum anterior-posterior (SLAP) repair for type 2 SLAP tears in young military patients. Over 10 years, 40% of SLAP repairs failed, requiring revision, while biceps tenodesis showed no revisions and better patient-reported results.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Shoulder Reconstruction
Background:
- Type 2 SLAP tears are common in active individuals.
- Biceps tenodesis has shown short-term advantages over SLAP repair.
- Long-term data on patient outcomes and revision rates are limited.
Purpose of the Study:
- To compare minimum 10-year outcomes of arthroscopic SLAP repair versus mini-open subpectoral biceps tenodesis.
- Focus on active-duty military patients under 35 with type 2 SLAP tears.
Main Methods:
- Level 3 cohort study.
- Included 25 SLAP repairs and 23 biceps tenodesis cases with ≥10 years follow-up.
- Assessed patient characteristics, outcomes, range of motion, complications, and return to duty.
Main Results:
- 40% of SLAP repairs failed, necessitating revision to tenodesis.
- Biceps tenodesis had significantly higher rates of substantial clinical benefit and patient acceptable symptom state.
- No patients who initially received biceps tenodesis required revision surgery.
Conclusions:
- Biceps tenodesis is superior to SLAP repair for type 2 SLAP tears in this cohort.
- SLAP repair failure rate was 40% at 10-year follow-up.
- Biceps tenodesis offers better long-term patient-reported outcomes and lower revision rates.
