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SLAP Lesion/Tear
SLAP stands for superior labrum anterior to posterior. A SLAP lesion means that a tear has occurred at the point where the tendon of the biceps muscles inserts on the labrum.
A SLAP lesion or tear can occur in several ways. The most common is through repetitive overhead arm motion, such as the act of throwing, with accompanying tension on the biceps. Falls onto a supporting, outstretched hand or lifting a heavy object may also trigger this injury.
Treatment
Conservative, non-operative treatment is most often recommended for patients with SLAP tears. Rest is most commonly prescribed after injury to allow the injured tissue to cool down. A period of rest will also allow any inflammation to subside and may help to alleviate symptoms. The attending physician may also prescribe anti-inflammatory medication along with physical therapy. In some patients, it may be advisable to prescribe cortisone injections to help relieve pain.
If patients continue to exhibit symptoms after a period of conservative treatment, then arthroscopic surgery of the shoulder should be considered. There are a variety of specific surgical procedures that may be performed, and it is essential to remember that SLAP tears are often accompanied by other shoulder problems such as rotator cuff tears and possibly arthritis.
In these cases, any surgical treatment would have to take these factors into account. The most common treatment procedures for SLAP tears are:
*SLAP tear debridement. In this procedure the torn portion of the labrum is trimmed away to create a smooth edge. However, this option is only practical for minor tears that do not involve the biceps tendon.
*SLAP repair. With the aid of an arthroscope, sutures with attached anchors are used to re-secure the torn labrum to the shoulder socket. This type of SLAP repair is often prescribed for patients with basically healthy shoulders who plan to remain athletic.
*Biceps tendodesis. This is the procedure that cuts the attachment of the biceps tendon to the labrum and then reattaches it to the bone of the humerus. By performing a biceps tendodesis, the pressure is thereby removed off the labrum in the shoulder and a portion of the biceps tendon can then be surgically removed. A biceps tendodesis can either be performed through a small incision over the top of the shoulder, or arthroscopically. Other conditions being treated within the shoulder joint should help determine how to best perform a biceps tendodesis. |
