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Park, Lee, and Lee: Problem Solving for Failed Superior Labrum Anterior to Posterior (SLAP) Repair
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Superior Labrum Anterior to Posterior (SLAP) Lesion: Controversial Issue

Journal of the Korean Orthopaedic Association 2017; 52(5): 385-391.

Published online: 30 October 2017

DOI: https://doi.org/10.4055/jkoa.2017.52.5.385

Problem Solving for Failed Superior Labrum Anterior to Posterior (SLAP) Repair

Jin-Young Park, M.D., Ph.D., Jae-Hyung Lee, M.D., Joon-Gyu Lee, M.D.

Center for Shoulder, Elbow and Sports, Neon Orthopaedic Clinic, Seoul, Korea.

Correspondence to: Jae-Hyung Lee, M.D. Center for Shoulder, Elbow and Sports, Neon Orthopaedic Clinic, 8 Seolleung-ro 131-gil, Gangnam-gu, Seoul 06059, Korea. TEL: +82-2-540-3200, FAX: +82-2-540-2299, medos97@naver.com

Received 18 April 2016       Revised 3 March 2017       Accepted 23 August 2017

Copyright © 2017 by The Korean Orthopaedic Association

The Korean Orthopaedic Association

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Stiffness and pain are major causes of failed superior labral anterior to posterior (SLAP) repair. The term, ‘failed SLAP repair’, can be defined as stiffness or pain without rotator cuff tears, acromio-clavicular pathology, arthritis, impingement syndrome, and other shoulder diseases. Moreover, it does not respond to conservative management. Generally, for failed SLAP repair, the initial conservative management includes physical therapy, strengthening exercise, oral medications, and injections. In addition, with failed conservative treatment, surgical intervention can be carried out. Surgical indications must be in consideration with patients' age, mechanism of injury, stability of the lesion, activity, former history of sports activity, and types of sports. Surgical treatments include debridement, SLAP repair, biceps tenodesis and tenotomy. However, each type of surgical method is controversial on both indications and prognosis. Surgical treatment on SLAP lesion is increasing, and studies on failed SLAP repair are expanding. The recommended first line therapy for failed SLAP lesion is conservative management, and with limited and thorough indications, surgical treatment yields good results, depending on concurrent lesions. However, authors recommend that it is important to seek for adjacent lesions prior to the initial SLAP repair to decrease failed SLAP repair.

Keywords: superior labral anterior to posterior, failed superior labral anterior to posterior repair, tenotomy, tenodesis

Figures and Tables

Figure 1

Magnetic resonance angiography finding of the re-torn site after superior labrum repair; a contrast material leakage in superior labrum and showing high signal intensity between superior labrum and superior glenoid.

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Figure 2

Loose stitch after failed superior labral anterior to posterior repair.

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Figure 3

Removal of loose stitch.

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Figure 4

Complete removal of the loose stitch and insertion of suture anchor after decortication of the superior glenoid.

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Figure 5

Arthroscopic finding after repair of failed superior labral anterior to posterior lesion.

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Notes

CONFLICTS OF INTEREST The authors have nothing to disclose.

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