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Slap conservative treatment

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
Sreehari C K, Ankit Varshney, Yon-Sik Yoo, Seung-Jin Lee
Spinoglenoid cyst (SGC) is a ganglion arising in the spinoglenoid notch and is thought to be related to SLAP lesion. This cyst often compresses the suprascapular nerve in the spinoglenoid notch. Symptomatic cysts require surgical treatment when conservative treatment fails. In particular, arthroscopic decompression through the torn labral tissue when the cyst is extending into the joint cavity is easy and convenient. However, if the cyst is confined to the spinoglenoid notch, arthroscopic approach through the torn labral tissue is challenging...
October 2017: Arthroscopy Techniques
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
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
Gregory S Van Blarcum, Steven J Svoboda
Glenohumeral instability is one of the more common conditions seen by sports medicine physicians, especially in young, active athletes. The associated anatomy of the glenohumeral joint (the shallow nature of the glenoid and the increased motion it allows) make the shoulder more prone to instability events as compared with other joints. Although traumatic dislocations or instability events associated with acute labral tears (ie, Bankart lesions) are well described in the literature, there exists other special shoulder conditions that are also associated with shoulder instability: superior labrum anterior/posterior (SLAP) tears, pan-labral tears, and multidirectional instability...
September 2017: Sports Medicine and Arthroscopy Review
Seok Hahn, Young Han Lee, Yong-Min Chun, Eun Hae Park, Jin-Suck Suh
Background Specific findings on magnetic resonance arthrography (MRA) that indicate the need for surgery in patients with partial articular-sided supraspinatus tendon avulsion (PASTA) are not well understood. Purpose To determine which MRA findings are characteristic of patients who undergo surgery for PASTA. Material and Methods From July 2011 to February 2014, MRA findings for patients treated for PASTA were retrospectively reviewed. The patients were divided into two groups: conservative treatment and surgical repair...
September 2017: Acta Radiologica
Arif Karmali, Jennifer McLeod
OBJECTIVE: To present the assessment and conservative management of chronic shoulder pain in the presence of a humeral avulsion of the inferior glenohumeral ligament (HAGL) lesion in an active individual. CLINICAL FEATURES: A 47 year-old female office-worker with constant, deep, right shoulder pain with occasional clicking and catching claimed to have "tore something" in her right shoulder five years ago while performing reverse bicep curls. A physical exam led to differential diagnoses of a Superior Labrum Anterior to Posterior (SLAP) lesion, Bankart lesion, and bicipital tendinopathy...
June 2016: Journal of the Canadian Chiropractic Association
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
Matthias Brockmeyer, Marc Tompkins, Dieter M Kohn, Olaf Lorbach
Tears of the superior labrum involving the biceps anchor are a common entity, especially in athletes, and may highly impair shoulder function. If conservative treatment fails, successful arthroscopic repair of symptomatic SLAP lesions has been described in the literature particularly for young athletes. However, the results in throwing athletes are less successful with a significant amount of patients who will not regain their pre-injury level of performance. The clinical results of SLAP repairs in middle-aged and older patients are mixed, with worse results and higher revision rates as compared to younger patients...
February 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Suk-Hwan Jang, Jeong-Gook Seo, Ho-Su Jang, Jae-Eun Jung, Jin-Goo Kim
BACKGROUND: Uncertainty remains in the natural course of superior labrum anterior-posterior (SLAP) tears treated conservatively with rehabilitation and activity modification. Our purpose was to evaluate clinical outcomes after nonoperative treatment of type II SLAP tear in young active patients and to identify factors related to negative outcomes. METHODS: We retrospectively reviewed 63 patients who initially underwent nonoperative treatment for isolated type II SLAP tear...
March 2016: Journal of Shoulder and Elbow Surgery
Marc-André Blanchette, Ai-Thu Pham, Julie-Marthe Grenier
This case report describes the clinical presentation and conservative treatment of a patient who suffered from a superior labrum anteroposterior (SLAP) tear of the shoulder after a rock climbing session. The 26 year old man had injured his right shoulder while trying to reach a distant socket with his shoulder 90° abducted and in extreme external rotation. After initial treatment failure in chiropractic, the patient sought an orthopaedist and physiotherapy care. A contrast magnetic resonance examination revealed a SLAP lesion...
September 2015: Journal of the Canadian Chiropractic Association
Christina D Davlin, Dave Fluker
An unfused acromial epiphysis, called os acromiale, can become unstable and mobile when the deltoid contracts. This may cause pain and lead to impingement syndrome and rotator cuff tearing. After sustaining a direct blow to the right shoulder, a male division I basketball player was diagnosed with impingement syndrome and an os acromiale. Following failed conservative treatment, the athlete underwent arthroscopic subacromial decompression & debridement of the loose os acromiale in the right shoulder. One year later, following a fall on the left shoulder, the athlete was diagnosed with os acromiale, impingement syndrome and a superior labrum anterior-posterior (SLAP) lesion...
December 2003: Journal of Sports Science & Medicine
Ian G Horsley, Elizabeth M Fowler, Christer G Rolf
BACKGROUND: In the literature, little is known about the level and pattern of rugby injuries. Of the shoulder injuries reported, 51% of these are caused during a tackle, and 65% of all match injuries affected the shoulder. OBJECTIVE: The study aims to describe a sport-specific unique intra-articular shoulder pathology of professional rugby players, who presented with persistent pain and dysfunction despite physiotherapeutic treatment and rest. METHOD: This study is a retrospective analysis set at a university sports medicine clinic...
April 26, 2013: Journal of Orthopaedic Surgery and Research
Kerem Bilsel, Mehmet Erdil, Mehmet Elmadag, Vahit Emre Ozden, Derya Celik, Ibrahim Tuncay
PURPOSE: Patients with spinoglenoid notch cyst associated with superior labrum anterior-to-posterior (SLAP) lesions were evaluated. The patients were all treated by arthroscopic cyst decompression combined with SLAP repair. The hypothesis of the study was that the patients who underwent prolonged conservative treatment period prior to surgery would exhibit significant infraspinatus hypotrophy and weakness, and their postoperative clinical and functional outcomes would be less satisfactory...
September 2014: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Ga Young Park, Hayoung Byun, Il Joon Moon, Sung Hwa Hong, Yang-Sun Cho, Won-Ho Chung
OBJECTIVES: Treatment of traumatic perilymph fistula (PLF) remains controversial between surgical repair and conservative therapy. The aim of this study is to analyze the outcomes of early surgical exploration in suspected barotraumatic PLF. METHODS: Nine patients (10 cases) who developed sudden sensorineural hearing loss and dizziness following barotrauma and underwent surgical exploration with the clinical impression of PLF were enrolled. Types of antecedent trauma, operative findings, control of dizziness after surgery, postoperative hearing outcomes, and relations to the time interval between traumatic event and surgery were assessed retrospectively...
June 2012: Clinical and Experimental Otorhinolaryngology
Brian Forsythe, Scott D Martin
BACKGROUND: The outcomes of combined arthroscopic repairs of a SLAP (superior labral anterior-posterior) lesion and a rotator cuff tear are not known. We compared the outcomes in a cohort of patients who had undergone concomitant arthroscopic repairs of a SLAP lesion and a rotator cuff tear with those in a cohort of patients with a stable biceps anchor who had undergone an isolated rotator cuff repair. We hypothesized that the results would be similar between the two cohorts with respect to the range of motion and preoperative and postoperative function...
March 2011: Journal of Bone and Joint Surgery. American Volume
Robert Manske, Daniel Prohaska
Due to the complexity of shoulder pathomechanics in the overhead athlete, injuries located in the superior aspect of the glenoid, known as superior labral anterior to posterior (SLAP) lesions, are often a surgical and rehabilitation challenge. In an effort to determine surgical versus conservative care of SLAP lesions a thorough clinical examination and evaluation are necessary. If surgery is identified as the treatment of choice, post operative rehabilitation will vary pending surgical findings including the extent and location of the SLAP lesion, and other concomitant findings and procedures...
November 2010: Physical Therapy in Sport
Brian Forsythe, Daniel Guss, Shawn G Anthony, Scott D Martin
BACKGROUND: The outcomes of combined arthroscopic repairs of a SLAP (superior labral anterior-posterior) lesion and a rotator cuff tear are not known. We compared the outcomes in a cohort of patients who had undergone concomitant arthroscopic repairs of a SLAP lesion and a rotator cuff tear with those in a cohort of patients with a stable biceps anchor who had undergone an isolated rotator cuff repair. We hypothesized that the results would be similar between the two cohorts with respect to the range of motion and preoperative and postoperative function...
June 2010: Journal of Bone and Joint Surgery. American Volume
V Dvorák
From May to December 1996 the author treated at his Clinic five patients with injuries of the anchoring of the labrum superior and anchoring of the long head of the biceps. Snyder describes these injuries as SLAP -superior labrum anterior posterior. Only the development of arthroscopic technique provided new findings on these lesions. Anamnestic data and the clinical picture closely resemble the impingement syndrome. Here too irritation of the rotator cuff occurs but the cause is intraarticular. Theoretical work provides evidence that injuries of this type lead to reduction of the torsion rigidity of the shoulder joint reduced tension of the lower glenohumeral ligament...
1997: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
Geoffrey D Abrams, Marc R Safran
Shoulder pain is a common complaint in overhead athletes, and superior labrum anterior posterior (SLAP) lesions are a common cause of this pain. The pathological cascade which results in the SLAP lesion consists of a combination of posterior inferior capsular tightness and scapular dyskinesis, resulting in a 'peel back' phenomenon at the biceps anchor and leading to the SLAP tear. Physical exam tests vary in their sensitivity and specificity in detecting SLAP lesions, so MRI is helpful in demonstrating the anatomical alteration...
April 2010: British Journal of Sports Medicine
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