SLAP Tear

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SLAP Tear (Superior Labral tear from anterior to Posterior) tear.
Dr.Senthilvelan
Consultant Orthopaedic Surgeon
For Appointments and Queries
Contact 9566222533/nexusortho@yahoo.com

What is SLAP Tear ?
The biceps tendon is attached to the superior aspect of the socket of the shoulder by means of a fibrocartilagenous extension. SLAP tear (Superior Labral tear from anterior to Posterior) represents a damage to this area. There are different types of SLAP tears, varying in different grades of severity (7 grades). The tears range from degeneration/fraying to extension to the rest of the glenoid labrum (fibrocartilagenous rim structure of the socket).

IMG_013
Arthroscopic view of SLAP tear

Which group of patients commonly get SLAP tear?
Although any patient can sustain a SLAP tear, sports persons involved especially in overhead activities frequently develop this lesion. Eg : volleyball players.

What symptoms do you get if you have a SLAP tear?
Dull throbbing ache over the shoulder
Pain /clicking on certain movement of shoulder(especially with arm across the body)
Difficulty in carrying on with overhead sporting activities.
Pain disturbing the sleep

What are the treatment options?
Most patients require surgical intervention to return back to sports. Although physiotherapy and conditioning excercises play a key role, they are usually supplementary to the surgery.

When is surgery indicated?
When the symptoms are worse to stop activities, confirmation of the diagnosis is done by clinical examination and imaging (MRI arthrogram). When SLAP tear is confirmed on investigation, initial treatment is by analgesics and physiotherapy. When conservative measures fail to improve symptoms, surgery is indicated.

MR Arthrogram showing SLAP tear
MR Arthrogram showing SLAP tear

What is involved in the surgery?
Surgery is done by arthroscopic method (key hole). The advantage of having key hole surgery is recovery is quicker, better access to the problem area than open surgery and minimal scarring.
The biceps anchor which is detached from the superior aspect of the glenoid (socket) is reattached by suture anchors.

Arthroscopic SLAP repair being carried out.
Arthroscopic SLAP repair being carried out.
Arthroscopic view of final repair using Knotless anchors.
Arthroscopic view of final repair using Knotless anchors.

What is the rehab protocol followed?
For the first 4 weeks, arm is rested in a sling allowing only pendulum movements only. This period is for allowing the tissues to heal back on to the bone. After 4 weeks a Specialist shoulder physiotherapist will start muscle strengthening excercises aiming to regain full range of movement.

When can patients resume driving?
Usually by 4-6 weeks

When can patients return to sports after surgery?
It will take 5-6 months before Overhead sporting activities can be resumed at competitive level.