Arthroscopic treatment of type II superior labral anterior to posterior (SLAP) lesions in a younger population: minimum 2-year outcomes are similar between SLAP repair and biceps tenodesis

Abstract

Purpose

Compared to a relatively older population over 30–40 years of age, the efficacy of biceps tenodesis for type II SLAP lesions in a younger population is not well studied. The purpose of this study was to compare outcomes between biceps tenodesis and labral repair for type II SLAP lesions in a young active population.

Methods

Patients aged 15–40 who underwent primary arthroscopic biceps tenodesis or SLAP repair for type II SLAP tears between 2009 and 2016 were included. Shoulders with intraarticular chondral damage, full thickness rotator cuff tear, rotator cuff repair, labral repair outside of the superior labrum, bony subacromial decompression, and acromioclavicular joint resection were excluded. Patient-reported outcomes were evaluated using the American Shoulder and Elbow Surgeons (ASES) score, Disabilities of the Arm, Shoulder, and Hand Sports/Performing Arts Module (DASH-sport), visual analog scale (VAS) for pain, and satisfaction. Return to sport rates were also recorded.

Results

Fifty-three patients (20 tenodesis, 33 repair) were available for minimum 2-year follow-up. Postoperatively, there were no significant differences in mean ASES, DASH-sport, VAS, and satisfaction between groups [ASES: tenodesis 86.3 vs. repair 86.4 (n.s.); DASH-sport: 11.0 vs. 22.5 (n.s.); VAS: 1.85 vs. 1.64 (n.s.); satisfaction: 8.50 vs. 8.00 (n.s.)]. Rate of return to pre-injury level of performance/competition in sport/physical activity was also similar between groups [tenodesis 63% vs. repair 50% (n.s.)].

Conclusions

In a young active population, primary arthroscopic biceps tenodesis is a viable surgical alternative to labral repair for type II SLAP lesions. The results of this study suggest that indications for arthroscopic tenodesis can safely be expanded to a younger patient group than has previously been demonstrated in the literature.

Level of evidence

III.

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Fig. 1
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Abbreviations

ASES:

American shoulder and elbow surgeons score

DASH-sport:

Disabilities of the arm, shoulder, and hand sports/performing arts module

PRO:

Patient-reported outcome

SLAP:

Superior labral anterior to posterior

VAS:

Visual analog scale

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Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

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Authors

Contributions

MAT conceived the study idea and served as principal investigator. SG and MAT performed the surgeries that were studied and revised the manuscript for important intellectual content. KFD designed the study, acquired data, analyzed the data, and wrote the manuscript. BDR, CJC, HPB, and CAK contributed to the acquisition of data and drafting of the manuscript. MK and VKT contributed to the design of the study and revised the manuscript for important intellectual content. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Kevin F. Dunne.

Ethics declarations

Conflict of interest

Michael A. Terry MD receives consulting compensation and financial support for the sports medicine fellowship at Northwestern from Smith and Nephew. Vehniah K. Tjong MD receives consulting compensation from Smith and Nephew. No financial support was received for conducting this study. Kevin F. Dunne MD, Michael Knesek MD, Brett D. Riederman MD, Charles J. Cogan MD, Hayden P. Baker MD, Cynthia A. Kahlenberg MD, and Stephen Gryzlo MD declare that they have no conflict of interest.

Ethical approval

Study protocol was approved by the Institutional Review Board (ID STU00200706, Northwestern University). Informed consent was obtained by each patient in the study. The study was done in agreement with the ethical standards of the Institutional Review Board and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Dunne, K.F., Knesek, M., Tjong, V.K. et al. Arthroscopic treatment of type II superior labral anterior to posterior (SLAP) lesions in a younger population: minimum 2-year outcomes are similar between SLAP repair and biceps tenodesis. Knee Surg Sports Traumatol Arthrosc 29, 257–265 (2021). https://doi.org/10.1007/s00167-020-05971-0

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Keywords

  • Shoulder
  • Biceps anchor
  • SLAP tear
  • SLAP repair
  • Biceps tenodesis
  • Shoulder arthroscopy