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Clinical Practice (assessment, diagnosis, treatment, knowledge translation/EBP, implementation science, program development)

Current Best Treatment for Superior Labrum, Anterior to Posterior tears

Thursday, November 10, 2022

4:20 PM – 4:25 PM

Location: Station 1

Presenting Author(s)

ES

Elis Sassi, SPT

Student Physical Therapy
Northern Illinois University, United States
AG

Ashley Gaca

Student Physical Therapist
Northern Illinois University, United States

Non-presenting Author(s)

Hamid Bateni, PhD

Associate Professor
Northern Illinois University
Dekalb, Illinois, United States

Objective(s): To investigate the current best treatment approach in regards to surgical and non-surgical approaches for Superior Labrum, Anterior to Posterior (SLAP) tears in the young athlete and older working adult population.

Data Sources: Google Scholar, PubMed, and ScienceDirect were searched for the terms(SLAP repair, biceps tenodesis, SLAP lesion, arthroscopic SLAP repair, and SLAP treatment).The search was limited to articles published between 2017 to present, English language and human participants.

Study Selection: Studies were selected based on approaches to SLAP tear i.e.: conservative rehabilitation, biceps tenodesis, SLAP repair, and combined biceps tenodesis with SLAP repair. From 31 articles that were initially adopted, 23 were selected and included in our review.

Data Extraction: Three reviewers independently reviewed each article and noted information provided in each article. The information included treatment methods (surgical vs rehabilitative) as well as differences in surgical approaches, return to play after various treatment methods, and cost analysis of various surgical approaches.

Data Synthesis: Individuals older than 35-40 with biceps tenodesis have lower risks of complications and revisions, decreased stiffness, less pain, and higher satisfaction rates with BT. SLAP repairs show better outcomes with younger athletes, SLAP repair in overhead athletes often leds to additional surgeries. However, no significant differences were found between the SLAP repair and BT for the overhead athletes. A combined SLAP repair and BT approach has shown the worst outcomes with less mobility, lower outcome measure scores, and increased pain. A conservative approach for 3 to 6 months however, is recommended before surgical options are considered.

Conclusions: Based on the current evidence, it appears that BT is an optimal choice for younger, less competitive athletes, as well as those individuals above the age of 35. Less favorable outcomes have been reported with the BT approach for competitive athletes and baseball pitchers; therefore, the healthcare team must work closely to determine the next best option on an individual basis.

Author(s) Disclosures: There are no conflict of interest associated with this study for any of the authors.

Learning Objectives:

Biceps tenodesis reveals better results in athletes and individuals older than 35 years old.
Superior Labrum, Anterior to Posterior (SLAP) often reveals a better results in younger athletes, but often leads to additional surgeries.
For individuals with Superior Labrum, Anterior to Posterior (SLAP) tears, a conservative approach for 3 to 6 months is recommended before surgical options are considered.