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Slap repairs

William Rossy, George Sanchez, Anthony Sanchez, Matthew T Provencher
CONTEXT: Given the notable physical demands placed on active members of the military, comprehension of recent trends in management and outcomes of superior labral anterior-posterior (SLAP) tears in this patient population is critical for successful treatment. EVIDENCE ACQUISITION: Electronic databases, including PubMed, MEDLINE, and Embase, were reviewed for the years 1985 through 2016. STUDY DESIGN: Database review. LEVEL OF EVIDENCE: Level 5...
October 7, 2016: Sports Health
Matthew T Provencher
Although superior labrum anterior posterior (SLAP) repairs have a relatively high success rate, emerging evidence suggests that this is not always the case. The authors of "Subsequent Shoulder Surgery Following Isolated Arthroscopic SLAP Repair" reveal that 1 in 10 people needed additional surgery within 3 years after SLAP repair-mainly for disorders of the rotator cuff, biceps, and distal clavicle. This underscores the fact that SLAP tears rarely occur in isolation and that the initial diagnosis and management may require more than just SLAP work...
October 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Robert Thorsness, Jeremy A Alland, Colin B McCulloch, Anthony Romeo
The throwing athlete's shoulder is a unique, complex entity with challenges in diagnosis and management. The shoulders in these athletes possess unique biomechanics and pathologic conditions. Unfortunately, return to play outcomes are often poor when specifically evaluating overhead athletes, especially with regard to SLAP repair. It is imperative for the surgeon to be cautious when indicating these athletes for surgery, because although they may demonstrate improvements in pain and general function, subtle changes in accuracy or velocity as a result of surgery can significantly affect the success of an overhead throwing athlete at the competitive level...
October 2016: Clinics in Sports Medicine
Michael E Steinhaus, Eric C Makhni, Adam C Lieber, Cynthia A Kahlenberg, Lawrence V Gulotta, Anthony A Romeo, Nikhil N Verma
BACKGROUND: Outcomes assessments after superior labrum anterior and posterior (SLAP) tear/repair are highly varied, making it difficult to draw comparisons across the literature. This study examined the inconsistency in outcomes reporting in the SLAP tear literature. We hypothesize that there is significant variability in outcomes reporting and that although most studies may report return to play, time to return reporting will be highly variable. METHODS: The PubMed, Medline, Scopus, and Embase databases were systematically reviewed for studies from January 2000 to December 2014 reporting outcomes after SLAP tear/repair...
November 2016: Journal of Shoulder and Elbow Surgery
M Beirer, G H Sandmann, A B Imhoff, S Buchmann
OBJECTIVE: To restore the physiologic anterior and posterior capsular volume to achieve an anatomic central contact point of the glenohumeral articulation and treatment of concomitant glenohumeral injuries due to posterosuperior impingement (PSI). INDICATIONS: Plateauing of clinical improvement despite adequate nonsurgical treatment (for at least 6-12 months). CONTRAINDICATIONS: General contraindications for elective arthroscopic surgery...
July 28, 2016: Operative Orthopädie und Traumatologie
Sang-Jin Shin, Juyeob Lee, Yoon-Sang Jeon, Young-Won Ko, Rag-Gyu Kim
PURPOSE: In the present prospective study, the functional outcomes of non-operative treatment were evaluated in patients aged between 30 and 45 years presenting SLAP lesion in diagnostic provocative tests and magnetic resonance (MR) arthrography. METHODS: Forty-six patients with a symptomatic SLAP lesion who participated in recreational level of sports were prospectively enroled. SLAP lesion was diagnosed using combinations of several clinical tests and MR arthrography findings...
June 24, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Marcus Robert Chia, Cameron Hatrick
Arthroscopic repair of lesions of the superior labrum and biceps anchor has been shown to provide good to excellent results. We describe a simplified arthroscopic surgical technique using a single knotless anchor with a mattress suture configuration. This technique provides an effective and reproducible method to reattach and re-create the normal appearance of the superior labrum and biceps anchor in a time-efficient manner without the need for knot tying.
December 2015: Arthroscopy Techniques
Jourdan M Cancienne, Stephen F Brockmeier, Brian C Werner
BACKGROUND: Although the general health consequences of tobacco use have been well defined, the effects of perioperative tobacco use on arthroscopic shoulder procedures remain largely unknown. The purpose of this study is to use a national database to investigate the relationship between tobacco use and rates of superior labrum anterior and posterior (SLAP) repair failure and postoperative infection after primary SLAP repair compared with matched controls. METHODS: A national private-payer insurance database was queried for patients who underwent arthroscopic primary SLAP from 2005-2012...
June 1, 2016: Journal of Shoulder and Elbow Surgery
Claire Marie C Durban, Je Kyun Kim, Sae Hoon Kim, Joo Han Oh
BACKGROUND: The aims of this study were to investigate the clinical characteristics of patients with combined anterior instability and superior labrum from anterior to posterior (SLAP) lesions, and to analyze the effect of concomitant SLAP repair on surgical outcomes. METHODS: We retrospectively reviewed patients who underwent arthroscopic stabilization for anterior shoulder instability between January 2004 and March 2013. A total of 120 patients were available for at least 1-year follow-up...
June 2016: Clinics in Orthopedic Surgery
Hiroshi Hashiguchi, Satoshi Iwashita, Atsushi Ohkubo, Shinro Takai
INTRODUCTION: A spinoglenoid cyst with suprascapular nerve disorders is highly associated with superior labrum anterior posterior (SLAP) lesion. Conservative or surgical treatment is applied to relieve pain and neurological symptoms. The purpose of this study was to evaluate clinical outcomes of patients treated by arthroscopic surgery for SLAP lesion with a spinoglenoid cyst. METHODS: The subjects of this study were six patients with SLAP lesion with a spinoglenoid cyst who underwent arthroscopic surgery...
2016: SICOT-J
Brent Mollon, Siddharth A Mahure, Kelsey L Ensor, Joseph D Zuckerman, Young W Kwon, Andrew S Rokito
PURPOSE: To quantify the incidence of and identify the risk factors for subsequent shoulder procedures after isolated SLAP repair. METHODS: New York's Statewide Planning and Research Cooperative System database was searched between 2003 and 2014 to identify individuals with the sole diagnosis of a SLAP lesion who underwent isolated arthroscopic SLAP repair. Patients were longitudinally followed up for a minimum of 3 years to analyze for subsequent ipsilateral shoulder procedures...
April 12, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Duncan Tennent, Eyiyemi Pearse
We describe a percutaneous technique for repair of type II SLAP lesions. Through the Neviaser portal, a spinal needle is used to pass a FiberStick suture (Arthrex, Naples, FL) through the labrum to create 2 mattress sutures that are secured with PushLock anchors (Arthrex). This technique is simple, reproducible, and knotless and requires no cannulas. At the end of the procedure, minimal suture material remains in the joint.
February 2016: Arthroscopy Techniques
Charles Milchteim, Scott A Tucker, Darin D Nye, Richard J Lamour, Wei Liu, James R Andrews, Roger V Ostrander
PURPOSE: To report a large number of highly active patients who underwent arthroscopic Bankart repair at our institution over the last decade. METHODS: A retrospective analysis of patients who underwent primary and revision arthroscopic Bankart repairs using bioabsorbable anchors was performed. Outcome measures included recurrence of dislocation, American Shoulder and Elbow Scores (ASES), Rowe, visual analog scale (VAS), return to sports, and satisfaction scores...
July 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Joshua D Harris
Both the quality and quantity of reporting in the SLAP repair literature, especially the surgical indications and technical intraoperative characteristics, leaves significant room for improvement. In their systematic review, Kibler and Sciascia identify this considerable underlying imprecision. Based on the current literature, no consensus exists for establishing any criteria for a successful SLAP repair--surgical indications, characteristics (type, location, number of anchors), completeness of repair, or rehabilitation...
April 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Baris Kocaoglu, Tekin Kerem Ulku, Safiye Sayilir, Mehmet Ugur Ozbaydar, Alp Bayramoglu, Mustafa Karahan
PURPOSE: The aim of our study was to evaluate the risk of medial glenoid perforation and possible injury to suprascapular nerve during arthroscopic SLAP repair using lateral transmuscular portal. METHODS: Ten cadaveric shoulder girdles were isolated and drilled at superior glenoid rim from both anterior-superior portal (1 o'clock) and lateral transmuscular portal (12 o'clock) for SLAP repairs. Drill hole depth was determined by the manufacturer's drill stop (20 mm), and any subsequent drill perforations through the medial bony surface of the glenoid were directly confirmed by dissection...
March 29, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Brandon J Erickson, Joshua D Harris, Yale A Fillingham, Gregory L Cvetanovich, Charles A Bush-Joseph, Bernard R Bach, Anthony A Romeo, Nikhil N Verma
PURPOSE: To determine practice patterns of Major League Baseball (MLB) team orthopaedic surgeons in addressing the controversial topics of ulnar collateral ligament (UCL) tears, type II SLAP tears, and partial-thickness rotator cuff tear. METHODS: Seventy-four MLB team orthopaedic surgeons were surveyed via an online survey system. A 14-question survey was used to assess surgeon experience, technique, and graft choice for UCL reconstruction (UCLR), treatment of type II SLAP tears, and other common pathologic conditions...
July 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Ashwin Rangavajjula, Adam Hyatt, Eli Raneses, Jim McCrossin, Steven Cohen, Peter DeLuca
OBJECTIVES: Shoulder labral injuries in professional hockey players are often treated surgically to minimize missed ice time. Previous studies have shown that post-operative outcomes in these players are favorable, although they have not specifically focused on athletic performance and time to return to sport. Our objective was to report time to return to play and post-operative on-ice performance metrics after shoulder labral repair in professional ice hockey players. METHODS: We performed a retrospective review of the clinical records of all professional hockey players (NHL) who underwent arthroscopic shoulder labral repair by one surgeon between January 2004 and December 2008...
2016: Physician and Sportsmedicine
Joo Han Oh, Ye Hyun Lee, Sae Hoon Kim, Ji Soon Park, Hyuk Jun Seo, Woo Kim, Hae Bong Park
PURPOSE: To compare the clinical outcomes in patients with concomitant superior labrum-biceps complex (SLBC) lesions and rotator cuff tears who underwent arthroscopic rotator cuff repair, according to 3 different treatment methods (simple debridement, biceps tenotomy, or biceps tenodesis) for the SLBC lesions. METHODS: One hundred twenty patients who underwent arthroscopic rotator cuff repair with SLBC lesions (biceps partial tears <50%, partial pulley lesions, and type II SLAP lesions) were enrolled in this prospective comparative study and randomly assigned to 1 of 3 treatment groups (simple debridement [Deb], biceps tenotomy only [BTo], or biceps tenodesis with one suture anchor [BTd])...
February 23, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Brandon J Erickson, Akshay Jain, Geoffrey D Abrams, Gregory P Nicholson, Brian J Cole, Anthony A Romeo, Nikhil N Verma
PURPOSE: To determine the trends in SLAP repairs over time, including patient age, and percentage of SLAP repairs versus other common shoulder arthroscopic procedures. METHODS: The records of 4 sports or shoulder/elbow fellowship trained orthopaedic surgeons were used to identify the total number of common shoulder arthroscopic cases performed between 2004 and 2014 using current procedural terminology codes (CPT): 29822, 29823, 29826, 29827, 29806, 29807, 29825, and 29828...
June 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Nata Parnes, Mario Ciani, Brian Carr, Paul Carey
The annual incidence and number of repairs of SLAP lesions in the United States are constantly increasing. Surgical repairs of type II SLAP lesions have overall good success rates. However, a low satisfaction rate and low rate of return to preinjury level of play remain a challenge with elite overhead and throwing athletes. Recent anatomic studies suggest that current surgical techniques over-tension the biceps anchor and the superior labrum. These studies suggest that restoration of the normal anatomy will improve clinical outcomes and sports performance...
October 2015: Arthroscopy Techniques
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