Superior Labral Anterior Posterior Lesions of the Shoulder (original) (raw)
Related papers
ARC Journal of Orthopedics, 2020
Andrews et al. (1) were the first to describe Superior glenoid labrum tears as a source of shoulder pain in the context of the high demand throwing athlete (professional baseball pitchers). The pathology correlated with the immense stress placed on the shoulder and the biceps brachial is muscle during the throwing motion. Snyder et al (2) authored the term Superior Labrum Anterior and Posterior (SLAP) tear to depict the pathology of the labrum in overhead tossing competitors. Superior labrum anterior to posterior (SLAP) sores are labral tears that stretch out from the posterior superior labrum, including the long head of the biceps tendon which originates from the glenoid labrum, and halting before the anterior glenoid notch (1). Lesions of the superior glenoid labrum and biceps anchor are a notable reason for shoulder torment (2). Advances in shoulder arthroscopy have prompted improvements in identification and treatment of superior labral anterior-posterior (SLAP) tears (3). Abstract
Treatment of superior labrum anterior posterior lesions: a literature review
ACTA ORTHOPAEDICA et TRAUMATOLOGICA TURCICA, 2014
Objective: Treatment of superior labrum anterior posterior (SLAP) lesions continues to be controversial, but with the development of suture anchors, it has become acceptable to repair these lesions arthroscopically. The aim of this study was to review recent trends in the evaluation and treatment of SLAP lesions, with particular emphasis on comparing the results of biceps tenodesis and SLAP repair. Methods: All English language publications from the PubMed, Cochrane, and SCOPUS databases between 1928 and 2012 on biceps tendon, SLAP lesions, and biceps surgery were reviewed. Literature was reviewed in table form because of the lack of Level 1 studies. Results: Surgical repair can have complications and may not return overhead athletes to their previous level of activity. Biceps tenodesis has become the preferred primary procedure in non-athletic individuals because of the high failure rate of SLAP repair. In patients with continuing symptoms after SLAP lesion repair, biceps tenodesis offers a more predictable operation than a second repair attempt. Conclusion: Biceps tenodesis may present a viable treatment option for SLAP repair or for failed SLAP repair in some patients.
Clinical and Imaging Assessment for Superior Labrum Anterior and Posterior Lesions
Current Sports Medicine Reports, 2009
In the evaluation of the painful shoulder, especially in the overhead athlete, diagnosing superior labrum anterior and posterior (SLAP) lesions continues to challenge the clinician because of 1) the lack of specificity of examination tests for SLAP; 2) a paucity of well-controlled studies of those tests; and 3) the presence of coexisting confounding abnormalities. Some evidence indicates that multiple positive tests increase the likelihood that a SLAP lesion is present, but no one physical examination finding conclusively makes that diagnosis. The goals of this article were to review the physical examination techniques for making the diagnosis of SLAP lesions, to evaluate the clinical usefulness of those examinations, and to review the role of magnetic resonance imaging in making the diagnosis.
Posttraumatic persistent shoulder pain: Superior labrum anterior-posterior (SLAP) lesions
The American journal of case reports, 2013
Male, 57 FINAL DIAGNOSIS: Typ 2 Superior labrum anterior-posterior lesion Symptoms: Shoulder pain after trauma Medication: - Clinical Procedure: - Specialty: Orthopedics and Traumatology • Emergency Medicine. Rare disease. Due to the anatomical and biomechanical characteristics of the shoulder, traumatic soft-tissue lesions are more common than osseous lesions. Superior labrum anterior-posterior (SLAP) lesions are an uncommon a cause of shoulder pain. SLAP is injury or separation of the glenoid labrum superior where the long head of biceps adheres. SLAP lesions are usually not seen on plain direct radiographs. Shoulder MRI and magnetic resonance arthrography are useful for diagnosis. A 57-year-old man was admitted to the emergency department due to a low fall on his shoulder. In physical examination, active and passive shoulder motion was normal except for painful extension. Anterior-posterior shoulder x-ray imaging was normal. The patient required orthopedics consultation in the em...
Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2008
The overall purpose of our study was to examine the sensitivity of physical examination, magnetic resonance imaging (MRI), and magnetic resonance (MR) arthrogram for the identification of arthroscopically confirmed SLAP lesions of the shoulder. Methods: An analysis of 51 consecutive patients with arthroscopically confirmed SLAP lesions and no history of shoulder dislocation was performed. Before undergoing surgery, all patients underwent a standardized physical examination and had either an MRI and/or MR arthrogram performed. Sensitivity analysis was then performed on the results of both the physical examination maneuvers and the radiologic imaging compared to the arthroscopic findings at surgery. Results: The sensitivity of O'Brien's (active compression) test was 90%, whereas the Mayo (dynamic) shear was 80% and Jobe's relocation test was 76%. The sensitivity of a physical examination with any 1 of these 3 SLAP provocative tests being positive was 100%. Neer's sign (41%) and Hawkin's impingement tests (31%) each had low sensitivity for SLAP lesions. The sensitivity of MRI for SLAP lesions was 67% when interpreted by the performing surgeon, 53% when read by a radiologist. When the MR arthrograms were analyzed alone, the sensitivity was 72% (surgeon) and 50% (radiologist), respectively. Conclusions: All 3 physical examination maneuvers traditionally considered provocative for SLAP pathology (O'Brien's, Mayo shear, and Jobe's relocation) were sensitive for the diagnosis of SLAP lesions. MRI and MR arthrogram imaging had lower sensitivity than these physical examination tests in diagnosing SLAP lesions. Patient history, demographics, and the surgeon's physical examination should remain central to the diagnosis of SLAP lesions. Level of Evidence: Level II, development of diagnostic criteria on basis of consecutive patients with universally applied gold standard.