Our Summary

SLAP lesions are common shoulder injuries, especially among athletes who often use overhead motions, like baseball or tennis players. They can cause significant pain and are difficult to diagnose and treat. The best treatment method depends on factors such as the patient’s age, sport, level of participation, and severity of symptoms.

Initially, less invasive treatments are recommended, especially for young, active individuals with no history of trauma. This can include rest, avoiding activities that worsen the injury, injections, and physical therapy. This approach can even allow 40% of professional baseball players to return to their sport.

However, if these treatments don’t work, or if the symptoms are too severe and prevent the individual from playing their sport or going about their daily activities, surgery might be necessary. There are two main types of surgery - arthroscopic repair and biceps tenodesis.

Arthroscopic repair, which involves fixing the damaged area, is typically recommended for younger athletes under 30 who play sports involving overhead motions. Biceps tenodesis, which involves fixing the bicep tendon, is usually recommended for middle-aged individuals, those who are receiving workers’ compensation, non-overhead athletes, or those with other shoulder injuries, like rotator cuff tears.

However, due to the relatively high failure rate of the first type of surgery, the biceps tenodesis procedure is becoming more popular. New research suggests it has good results and can help even younger athletes return to their sport.

FAQs

  1. What are SLAP lesions and who are most susceptible to them?
  2. What are the initial treatments recommended for SLAP lesions?
  3. What are the two main types of surgeries for SLAP lesions and who are they recommended for?

Doctor’s Tip

After surgery, it is important to follow the rehabilitation program provided by your doctor or physical therapist to ensure a successful recovery. This may include exercises to strengthen the shoulder, improve range of motion, and gradually return to normal activities. It is important to be patient and follow the guidance of your healthcare team to avoid re-injury and achieve the best outcome. Remember to communicate any concerns or changes in symptoms to your doctor throughout the recovery process.

Suitable For

Ultimately, the decision on which type of surgery to recommend depends on the individual patient’s specific circumstances, including their age, activity level, severity of symptoms, and any other shoulder injuries present. A thorough evaluation by a qualified orthopedic surgeon is necessary to determine the best course of treatment for each patient with a SLAP lesion.

Timeline

Before labral repair surgery, the patient will likely have tried conservative treatments like rest, physical therapy, and injections. They may have also undergone imaging tests like MRI to confirm the diagnosis and assess the extent of the injury.

After surgery, the patient will need to undergo a period of rehabilitation to regain strength and range of motion in the shoulder. This typically involves physical therapy and a gradual return to activities, with a focus on avoiding overhead motions and heavy lifting for a period of time.

Overall, the recovery timeline can vary depending on the individual, the type of surgery performed, and any other factors that may affect healing. It is important for patients to follow their surgeon and physical therapist’s guidance closely to ensure a successful recovery and return to their desired level of activity.

What to Ask Your Doctor

Some questions a patient should ask their doctor about labral repair include:

  1. What are the potential risks and complications associated with the surgery?
  2. How long is the recovery process and what can I expect in terms of pain and limitations?
  3. What type of physical therapy will be required after the surgery?
  4. Will I need to make any modifications to my lifestyle or activities after the surgery?
  5. How successful is this type of surgery in terms of pain relief and returning to sports or other activities?
  6. Are there any alternative treatment options that I should consider before opting for surgery?
  7. What is the expected outcome in terms of long-term shoulder function and stability?
  8. How many of these surgeries have you performed and what is your success rate?
  9. Will I need any additional procedures or treatments in the future to maintain the repair?
  10. Can you provide me with more information or resources to help me better understand the procedure and what to expect?

Reference

Authors: Fortier LM, Menendez ME, Kerzner B, Verma N, Verma NN. Journal: Arthroscopy. 2022 Dec;38(12):3103-3105. doi: 10.1016/j.arthro.2022.08.005. PMID: 36462776