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SLAP Tears

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https://www.readbyqxmd.com/read/29624450/national-athletic-trainers-association-position-statement-evaluation-management-and-outcomes-of-and-return-to-play-criteria-for-overhead-athletes-with-superior-labral-anterior-posterior-injuries
#1
Lori A Michener, Jeffrey S Abrams, Kellie C Huxel Bliven, Sue Falsone, Kevin G Laudner, Edward G McFarland, James E Tibone, Charles A Thigpen, Timothy L Uhl
OBJECTIVE:   To present recommendations for the diagnosis, management, outcomes, and return to play of athletes with superior labral anterior-posterior (SLAP) injuries. BACKGROUND:   In overhead athletes, SLAP tears are common as either acute or chronic injuries. The clinical guidelines presented here were developed based on a systematic review of the current evidence and the consensus of the writing panel. Clinicians can use these guidelines to inform decision making regarding the diagnosis, acute and long-term conservative and surgical treatment, and expected outcomes of and return-to-play guidelines for athletes with SLAP injuries...
March 2018: Journal of Athletic Training
https://www.readbyqxmd.com/read/29582321/diagnostic-performance-of-shoulder-magnetic-resonance-arthrography-for-labral-tears-having-surgery-as-reference-comparison-of-high-resolution-isotropic-3d-sequence-thrive-with-standard-protocol
#2
Sun Hwa Lee, Seong Jong Yun, Youngno Yoon
PURPOSE: To compare the diagnostic performance of T1 high-resolution isotropic volume excitation (THRIVE) sequence with that of a standard protocol for direct shoulder magnetic resonance arthrography (MRA) for the diagnosis of superior labral anterior-to-posterior (SLAP) and Bankart lesions, using arthroscopy findings as a reference standard. MATERIALS AND METHODS: We retrospectively studied 84 patients who underwent direct shoulder 3T MRA using THRIVE and two-dimensional three-plane proton-density fat-suppressed (2D-PD-FS) sequences...
March 26, 2018: La Radiologia Medica
https://www.readbyqxmd.com/read/29582141/diagnosis-of-glenoid-labral-tears-using-3-tesla-mri-vs-3-tesla-mra-a-systematic-review-and-meta-analysis
#3
Adil Ajuied, Ciaran P McGarvey, Ziad Harb, Christian C Smith, Russell P Houghton, Steven A Corbett
BACKGROUND: Various protocols exist for magnetic resonance arthrogram (MRA) of the shoulder, including 3D isotropic scanning and positioning in neutral (2D neutral MRA), or abduction-external-rotation (ABER). HYPOTHESIS: MRA does not improve diagnostic accuracy for labral tears when compared to magnetic resonance imaging (MRI) performed using 3-Tesla (3T) magnets. METHOD: Systematic review of the Cochrane, MEDLINE, and PubMed databases according to PRISMA guidelines...
March 26, 2018: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29573932/radiologic-and-histologic-evaluation-of-proximal-bicep-pathology-in-patients-with-chronic-biceps-tendinopathy-undergoing-open-subpectoral-biceps-tenodesis
#4
Clayton W Nuelle, Derek C Stokes, Keiichi Kuroki, Julia R Crim, Seth L Sherman
PURPOSE: To correlate preoperative magnetic resonance imaging (MRI) and intraoperative anatomic findings within the proximal long head biceps tendon to histologic evaluation of 3 separate zones of the tendon in patients with chronic biceps tendinopathy. METHODS: Sixteen patients with chronic biceps tendinopathy were treated with open subpectoral biceps tenodesis. Preoperative MRI tendon grading was as follows: normal tendon, increased signal, tendon splitting, incomplete/complete tear...
March 21, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29549380/imaging-of-the-post-operative-shoulder-does-injection-of-iodinated-contrast-in-addition-to-mr-contrast-during-arthrography-improve-diagnostic-accuracy-and-patient-throughput
#5
Thomas Magee
OBJECTIVE: Post-operative shoulder patients are often difficult to image due to scar tissue, metallic artifact, and residual irregularity of anatomic structures. The purpose of this study was to assess MR versus MR arthrography versus CT arthrography in the post-operative shoulder. Also, we assessed whether injecting CT contrast in addition to MR contrast during arthrography improved patient care. METHODS AND MATERIALS: One hundred consecutive post-operative conventional shoulder MR and MR arthrography exams performed on the same patients were reviewed retrospectively by two musculoskeletal radiologists...
March 17, 2018: Skeletal Radiology
https://www.readbyqxmd.com/read/29529954/comparative-study-on-clinical-results-of-arthroscopic-repair-of-anteroinferior-superior-and-combined-glenoid-labral-tear
#6
Meng Zhu, Jerry Yongqiang Chen, Hwei Chi Chong, Paul Chang Chee Cheng, Denny Lie Tijauw Tjoen
BACKGROUND: The purpose of this prospective study is to compare and correlate the clinical results of arthroscopic repair of a combined anteroinferior and superior labral lesion with those of an isolated anteroinferior labral lesion or type II superior labral tear from anterior to posterior (SLAP) lesion. METHODS: A comparative study involving patients who underwent arthroscopic labral repairs in a tertiary hospital between 2010 and 2014 was conducted. A total of 96 patients were divided into three groups: Group A consisted of 61 patients with the anteroinferior labral lesion, group B consisted of 16 patients with the type II SLAP lesion, and group C consisted of 19 patients with the combined anteroinferior and superior labral lesion...
January 2018: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/29502695/editorial-commentary-the-shoulder-biceps-tendon-and-baseball-continue-their-controversial-relationship
#7
EDITORIAL
Christopher S Ahmad
The optimal treatment of shoulder SLAP tears in high-level baseball players remains highly controversial. In pitchers, many SLAP lesions are found incidentally on magnetic resonance imaging and may in fact be adaptive to the baseball pitcher's mechanics of throwing. Surgical repair of SLAP lesions requires lengthy rehabilitation, and outcomes have been similar to or worse than the results after nonoperative treatment. The treatment option of biceps tenodesis is an appealing alternative to SLAP repair, but the indications and technique of biceps tenodesis in the elite pitcher still need to be defined...
March 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29447302/in-throwers-with-posterior-instability-rotator-cuff-tears-are-common-but-do-not-affect-surgical-outcomes
#8
Justin W Arner, Michael P McClincy, James P Bradley
In a previous study, compared with throwing athletes with superior labral anterior posterior (SLAP) tears, those with concomitant SLAP tears and rotator cuff tears (RCTs) had significantly poorer outcome scores and return to play. Posterior shoulder instability also occurs in throwing athletes, but no studies currently exist regarding outcomes of these patients with concomitant RCTs. The authors hypothesized that throwing athletes treated with arthroscopic capsulolabral repair for posterior shoulder instability with coexistent rotator cuff pathology would have poorer outcome scores and return to play...
January 2018: American Journal of Orthopedics
https://www.readbyqxmd.com/read/29362860/regional-histologic-differences-in-the-long-head-of-the-biceps-tendon-following-subpectoral-biceps-tenodesis-in-patients-with-rotator-cuff-tears-and-slap-lesions
#9
Sergio A Glait, Siddharth Mahure, Cynthia A Loomis, Michael Cammer, Hien Pham, Andrew Feldman, Laith M Jazrawi, Eric J Strauss
PURPOSE: The purpose of this study was to quantify the regional histology of the long head of the biceps tendon (LHBT) and compare the histopathology present to clinical findings in patients with rotator cuff tears and SLAP lesions. METHODS: Prospectively enrolled patients undergoing an open subpectoral LHBT tenodesis in the setting of a rotator cuff (RTC) tear or SLAP lesion. Perioperative data were collected and the excised LHBT was analyzed by a fellowship trained pathologist...
January 23, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29354478/arthroscopic-triple-labral-repair-in-an-adolescent
#10
Eric J Cotter, Rachel M Frank, Scott W Trenhaile
Traumatic glenohumeral dislocations often result in significant injury to the anterior-inferior labrum, most commonly leading to recurrent anterior instability. While in skeletally immature patients, shoulder trauma more commonly results in fracture versus a true dislocation, shoulder instability does occur and can be difficult to manage in the setting of open physes. In any event, the goal of treatment is to reduce the risk of recurrence and allow full participation in activities, including sports. Arthroscopic stabilization has been shown to be an effective treatment option for young patients, with good return to sport rates; however, the vast majority of literature on shoulder instability in the youth patient population focuses on anterior instability...
October 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29351746/concomitant-glenohumeral-injuries-in-neer-type-ii-distal-clavicle-fractures
#11
Tobias Helfen, Georg Siebenbürger, Florian Haasters, Wolfgang Böcker, Ben Ockert
BACKGROUND: To identify the prevalence of concomitant glenohumeral injuries in surgically treated Neer type II distal clavicle fractures and relate its clinical importance. METHODS: Between 11/2011 and 11/2015 41 patients, suffering from a displaced and unstable distal clavicle fracture were included. 20 patients (group 1) received surgical treatment by means of plate osteosynthesis in combination with an arthroscopically assisted coraco-clavicular ligament augmentation...
January 19, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29349009/arthroscopic-repair-of-type-ii-slap-tears-using-suture-anchor-technique
#12
Mathew Hamula, Siddharth A Mahure, Daniel J Kaplan, Brent Mollon, Joseph D Zuckerman, Young W Kwon, Andrew S Rokito
Arthroscopic SLAP tear repair has become an increasingly used treatment for patients presenting with symptomatic SLAP tears after failed nonoperative management. Debridement, SLAP repair, and open or arthroscopic biceps tenodesis or tenotomy have been used for the treatment of SLAP tears. Various techniques for repair have been described, and furthermore, there is a high incidence of concomitant pathology of the shoulder. Repair remains an excellent option in isolated SLAP tears amenable to repair, with excellent outcomes in well-indicated patients...
December 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29344768/diagnosis-and-treatment-of-injuries-to-the-biceps-and-superior-labral-complex-in-overhead-athletes
#13
REVIEW
Jacob G Calcei, Venkat Boddapati, David W Altchek, Christopher L Camp, Joshua S Dines
PURPOSE OF REVIEW: This review discusses the diagnostic and treatment challenges presented by injuries to the biceps and superior labral complex. RECENT FINDINGS: A focused patient history, numerous physical examination maneuvers, and appropriate advanced imaging studies must be utilized to reach an accurate diagnosis. Nonoperative management, even in overhead athletes, has demonstrated relatively good outcomes, while operative outcomes have yielded mixed results...
March 2018: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/29305621/-modern-treatment-strategies-for-the-long-head-of-the-biceps-tendon
#14
REVIEW
S Braun, A B Imhoff
The long head of the biceps and the biceps pulley sling are prone to acute or degenerative injury. As they both were identified as major pain generators, adequate diagnosis and treatment is vital for successful treatment of shoulder pain. Although the basic principles to address either pathology have not changed over the last decades, new trends have evolved to simplify surgical options. SLAP (superior labral tear from anterior to posterior) repair is seen more restrictive and is mostly performed in young individuals, whereas tenotomy or tenodesis are more often used in patients over 30...
February 2018: Der Orthopäde
https://www.readbyqxmd.com/read/29162079/examination-of-concomitant-glenohumeral-pathologies-in-patients-treated-arthroscopically-for-calcific-tendinitis-of-the-shoulder-and-implications-for-routine-diagnostic-joint-exploration
#15
Gernot Lang, Kaywan Izadpanah, Eva Johanna Kubosch, Dirk Maier, Norbert Südkamp, Peter Ogon
BACKGROUND: Glenohumeral exploration is routinely performed during arthroscopic removal of rotator cuff calcifications in patients with calcific tendinitis of the shoulder (CTS). However, evidence on the prevalence of intraarticular co-pathologies is lacking and the benefit of glenohumeral exploration remains elusive. The aim of the present study was to assess and quantify intraoperative pathologies during arthroscopic removal of rotator cuff calcifications in order to determine whether standardized diagnostic glenohumeral exploration appears justified in CTS patients...
November 21, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29153993/the-high-frequency-of-superior-labrum-biceps-tendon-and-superior-rotator-cuff-pathologies-in-patients-with-subscapularis-tears-a-cohort-study
#16
Muhammet Baybars Ataoglu, Mehmet Cetinkaya, Mustafa Ozer, Tacettin Ayanoglu, Ulunay Kanatli
BACKGROUND: The purpose of this study was to assess the frequency of superior labrum anterior posterior (SLAP) lesions, long head of biceps tendon (LHBT) pathologies, and superior rotator cuff tears accompanying subscapularis tears. We hypothesised that LHBT lesions, superior rotator cuff tears, and especially SLAP lesions were very frequent with subscapularis tears. METHODS: The digital files of patients who underwent shoulder arthroscopy were reviewed retrospectively...
November 16, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/29095396/mri-to-arthroscopy-correlations-in-slap-lesions-and-long-head-biceps-pathology
#17
K Linnea Welton, Justin H Bartley, Nancy M Major, Eric C McCarty
Superior labral anterior and posterior lesions and long head biceps injury are 2 common sources of shoulder pain. The presenting complaints and physical examination findings for these etiologies are often nonspecific, making diagnosis challenging. Further complicating their diagnoses, these 2 pathologies often cooccur together or with other shoulder pathologies such as subacromial bursitis, rotator cuff tear, and shoulder instability. However, with advancement in magnetic resonance imaging and shoulder arthroscopy techniques the ability to diagnose and treat these pathologies has vastly improved over the past 30 years...
December 2017: Sports Medicine and Arthroscopy Review
https://www.readbyqxmd.com/read/29038845/clinical-and-sonographic-evaluation-of-subpectoral-biceps-tenodesis-with-a-dual-suture-anchor-technique-demonstrates-improved-outcomes-and-a-low-failure-rate-at-a-minimum-2-year-follow-up
#18
Matthijs Jacxsens, Erin K Granger, Robert Z Tashjian
INTRODUCTION: The purpose of this study was to evaluate the clinical outcomes and integrity of an open subpectoral biceps tenodesis using a dual suture anchor construct. MATERIALS AND METHODS: Patients with at least 2 years of follow-up were retrospectively evaluated for simple shoulder test (SST), American Shoulder and Elbow Surgeons (ASES) score, and visual analog scales (VAS) for pain, function and satisfaction. A physical exam assessed shoulder range of motion and elbow strength...
January 2018: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29018839/clinical-assessment-of-physical-examination-maneuvers-for-superior-labral-anterior-to-posterior-lesions
#19
Lyndsay E Somerville, Kevin Willits, Andrew M Johnson, Robert Litchfield, Marie-Eve LeBel, Jaydeep Moro, Dianne Bryant
Purpose  Shoulder pain and disability pose a diagnostic challenge owing to the numerous etiologies and the potential for multiple disorders to exist simultaneously. The evidence to support the use of clinical tests for superior labral anterior to posterior complex (SLAP) is weak or absent. The purpose of this study is to determine the diagnostic validity of physical examination maneuvers for SLAP lesions by performing a methodologically rigorous, clinically applicable study. Methods  We recruited consecutive new shoulder patients reporting pain and/or disability...
October 2017: Surgery Journal
https://www.readbyqxmd.com/read/28979603/controversies-in-the-surgical-management-of-shoulder-instability-associated-soft-tissue-procedures
#20
Santos Moros Marco, José Luis Ávila Lafuente, Miguel Angel Ruiz Ibán, Jorge Diaz Heredia
BACKGROUND: The glenohumeral joint is a ball-and-socket joint that is inherently unstable and thus, susceptible to dislocation. The traditional and most common anatomic finding is the Bankart lesion (anterior-inferior capsule labral complex avulsion), but there is a wide variety of anatomic alterations that can cause shoulder instability or may be present as a concomitant injury or in combination, including bone loss (glenoid or humeral head), complex capsule-labral tears, rotator cuff tears, Kim´s lesions (injuries to the posterior-inferior labrum) and rotator interval pathology...
2017: Open Orthopaedics Journal
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