As stated previously, several surgical options are available. These include SLAP debridement, SLAP repair, and biceps tenodesis. A SLAP debridement simply removed any excess or damaged tissue that causes symptoms of catching and pain in the shoulder.
When is a SLAP repair an appropriate treatment?
A SLAP repair is considered for treatment when the attachment of the labrum (the so-called biceps anchor) is unstable. In these cases, debridement would not be adequate to alleviate the symptoms of the SLAP tear.
How is a SLAP repair performed?
A SLAP repair is performed arthroscopically using sutures to reattach the torn labrum back to the bone. The steps of a SLAP repair are:
- 1. The SLAP tear is identified and excess tissue is removed.
- 2. A small hole is drilled into the bone where the labrum has torn off (the SLAP tear).
- 3. An anchor is placed into this hole; attached to the anchor is a strong suture.
- 4. The suture is used to tie the torn labrum snuggly against the bone.
- A SLAP repair restores the normal anatomy of the shoulder by reattaching the labrum in its normal position.
- Once healed, the SLAP repair allows normal function of the previously damaged labrum and biceps attachment.
- The rehabilitation is often not as restrictive as is the case with a SLAP repair.
- The results of surgery are usually more predictable, as healing of a SLAP repair is not as reliable.
What is the rehab after a SLAP repair?
Rehabilitation varies depending on factors such as the strength of the SLAP repair, and the preference of the surgeon. Most often, a period of time of restricted motion is maintained for about six weeks following a SLAP repair. During this first phase of rehabilitation, some passive motion is allowed to prevent shoulder stiffness. In the first phase, the torn labrum is healing into its proper position.
Once healed, patients enter the second phase of rehabilitation and can begin more motion at about six weeks. Physical therapy continues to help maintain motion and regain strength of the shoulder. The final phase of rehabilitation involves more active strengthening of the muscles that surround the shoulder joint, and full recovery is expected between 3 to 4 months.
Sources:
Kim TK, et al. "Clinical features of the different types of SLAP lesions" Journal of Bone Joint Surgery Am. 2003 Jan;85-A(1):66-71.
Choi NH, Kim SJ. "Avulsion of the superior labrum"Arthroscopy. 2004 Oct;20(8):872-4.
