Superior labral lesions in the shoulder: pathoanatomy and surgical management

Progress in shoulder arthroscopy has led to the identification of previously undiagnosed lesions involving the superior labrum and the biceps tendon anchor. Additional research has substantiated the role of the long head of the biceps tendon in anterior and rotational glenohumeral stability. Careful attention to the history and physical examination and directed diagnostic imaging may arouse suspicion of injury to the biceps tendon and the superior labral complex. Identification of injuries to the superior labrum extending from anterior to posterior, or "SLAP" injuries, can be made with diagnostic glenohumeral arthroscopy. Appropriate treatment can then be based on the type of lesion encountered (generally, debridement of most type I and III lesions and repair of type II and many type IV lesions).