Skip to main content
Top
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 2/2016

01-02-2016 | Shoulder

Clinical outcome of arthroscopic SLAP repair: conventional vertical knot versus knotless horizontal mattress sutures

Authors: Hyuk Jae Yang, Kisyck Yoon, Hyonki Jin, Hyun Seok Song

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 2/2016

Login to get access

Abstract

Purpose

Arthroscopic repair of type II superior labrum anterior to posterior (SLAP) tears yields variable results. In this study, the clinical outcomes of arthroscopic knotless horizontal mattress repair were compared to those of conventional vertical knot repair.

Methods

Forty-six patients treated arthroscopically for isolated SLAP lesions were assessed. Forty-one of those patients underwent follow-up evaluations for a minimum of 2 years: 21 received vertical knot (group 1), while 20 received horizontal mattress (group 2). In group 1, an anchor was inserted at the superior glenoid. After relaying the sutures, knotting over the labral tissue was performed. In group 2, two strands were passed through the labrum and fixed into the glenoid with a bioabsorbable knotless anchor. Functional scores were evaluated preoperatively and at the final follow-up assessment. A visual analogue scale (VAS) for pain and range of motion (ROM) were assessed preoperatively, 2 months postoperatively and at the last follow-up visit.

Results

There were no significant differences in functional scores between groups (n.s.). However, external rotation at the side, internal rotation at abduction and total ROM were better in group 2 at the last follow-up visit. At 2 months postoperatively, the VAS for pain and ROM of internal rotation at abduction were better in group 2.

Conclusion

At the final assessment, there were no significant differences in functional scores between the two groups. However, external rotation at the side, internal rotation at abduction and total ROM were better in group 2.

Level of evidence

Case–control study, Level III.
Literature
1.
go back to reference Abbot AE, Li X, Busconi BD (2009) Arthroscopic treatment of concomitant superior labral anterior posterior (SLAP) lesions and rotator cuff tears in patients over the age of 45 years. Am J Sports Med 37:1358–1362CrossRefPubMed Abbot AE, Li X, Busconi BD (2009) Arthroscopic treatment of concomitant superior labral anterior posterior (SLAP) lesions and rotator cuff tears in patients over the age of 45 years. Am J Sports Med 37:1358–1362CrossRefPubMed
2.
go back to reference Boesmueller S, Mayerhofer S, Huf W, Fialka C (2012) Short-term clinical results after arthroscopic type II SLAP repair. Wien Klin Wochenschr 124:370–376CrossRefPubMed Boesmueller S, Mayerhofer S, Huf W, Fialka C (2012) Short-term clinical results after arthroscopic type II SLAP repair. Wien Klin Wochenschr 124:370–376CrossRefPubMed
3.
go back to reference Boileau P, Parratte S, Chuinard C, Roussanne Y, Shia D, Bicknell R (2009) Arthroscopic treatment of isolated type II SLAP lesions: biceps tenodesis as an alternative to reinsertion. Am J Sports Med 37:929–936CrossRefPubMed Boileau P, Parratte S, Chuinard C, Roussanne Y, Shia D, Bicknell R (2009) Arthroscopic treatment of isolated type II SLAP lesions: biceps tenodesis as an alternative to reinsertion. Am J Sports Med 37:929–936CrossRefPubMed
4.
go back to reference Burns JP, Bahk M, Snyder SJ (2011) Superior labral tears: repair versus biceps tenodesis. J Shoulder Elbow Surg 20:S2–S8CrossRefPubMed Burns JP, Bahk M, Snyder SJ (2011) Superior labral tears: repair versus biceps tenodesis. J Shoulder Elbow Surg 20:S2–S8CrossRefPubMed
5.
go back to reference Cohen DB, Coleman S, Drakos MC, Allen AA, O’Brien SJ, Altchek DW, Warren RF (2006) Outcomes of isolated type II SLAP lesions treated with arthroscopic fixation using a bioabsorbable tack. Arthroscopy 22:136–142CrossRefPubMed Cohen DB, Coleman S, Drakos MC, Allen AA, O’Brien SJ, Altchek DW, Warren RF (2006) Outcomes of isolated type II SLAP lesions treated with arthroscopic fixation using a bioabsorbable tack. Arthroscopy 22:136–142CrossRefPubMed
6.
go back to reference Denard PJ, Ladermann A, Burkhart SS (2012) Long-term outcome after arthroscopic repair of type II SLAP lesions: results according to age and workers’ compensation status. Arthroscopy 28:451–457CrossRefPubMed Denard PJ, Ladermann A, Burkhart SS (2012) Long-term outcome after arthroscopic repair of type II SLAP lesions: results according to age and workers’ compensation status. Arthroscopy 28:451–457CrossRefPubMed
7.
go back to reference Dines JS, Elattrache NS (2008) Horizontal mattress with a knotless anchor to better recreate the normal superior labrum anatomy. Arthroscopy 24:1422–1425CrossRefPubMed Dines JS, Elattrache NS (2008) Horizontal mattress with a knotless anchor to better recreate the normal superior labrum anatomy. Arthroscopy 24:1422–1425CrossRefPubMed
8.
go back to reference Domb BG, Ehteshami JR, Shindle MK, Gulotta L, Zoghi-Moghadam M, MacGillivray JD, Altchek DW (2007) Biomechanical comparison of 3 suture anchor configurations for repair of type II SLAP lesions. Arthroscopy 23:135–140CrossRefPubMed Domb BG, Ehteshami JR, Shindle MK, Gulotta L, Zoghi-Moghadam M, MacGillivray JD, Altchek DW (2007) Biomechanical comparison of 3 suture anchor configurations for repair of type II SLAP lesions. Arthroscopy 23:135–140CrossRefPubMed
9.
go back to reference Franceschi F, Longo UG, Ruzzini L, Rizzello G, Maffulli N, Denaro V (2008) No advantages in repairing a type II superior labrum anterior and posterior (SLAP) lesion when associated with rotator cuff repair in patients over age 50: a randomized controlled trial. Am J Sports Med 36:247–253CrossRefPubMed Franceschi F, Longo UG, Ruzzini L, Rizzello G, Maffulli N, Denaro V (2008) No advantages in repairing a type II superior labrum anterior and posterior (SLAP) lesion when associated with rotator cuff repair in patients over age 50: a randomized controlled trial. Am J Sports Med 36:247–253CrossRefPubMed
10.
go back to reference Ifesanya A, Scheibel M (2008) Posterosuperior suture granuloma impingement after arthroscopic SLAP repair using suture anchors: a case report. Knee Surg Sports Traumatol Arthrosc 16:703–706CrossRefPubMed Ifesanya A, Scheibel M (2008) Posterosuperior suture granuloma impingement after arthroscopic SLAP repair using suture anchors: a case report. Knee Surg Sports Traumatol Arthrosc 16:703–706CrossRefPubMed
11.
go back to reference Kartus J, Kartus C, Brownlow H, Burrow G, Perko M (2004) Repair of type-2 SLAP lesions using Corkscrew anchors. A preliminary report of the clinical results. Knee Surg Sports Traumatol Arthrosc 12:229–234CrossRefPubMed Kartus J, Kartus C, Brownlow H, Burrow G, Perko M (2004) Repair of type-2 SLAP lesions using Corkscrew anchors. A preliminary report of the clinical results. Knee Surg Sports Traumatol Arthrosc 12:229–234CrossRefPubMed
12.
go back to reference Katz LM, Hsu S, Miller SL, Richmond JC, Khetia E, Kohli N, Curtis AS (2009) Poor outcomes after SLAP repair: descriptive analysis and prognosis. Arthroscopy 25:849–855CrossRefPubMed Katz LM, Hsu S, Miller SL, Richmond JC, Khetia E, Kohli N, Curtis AS (2009) Poor outcomes after SLAP repair: descriptive analysis and prognosis. Arthroscopy 25:849–855CrossRefPubMed
13.
go back to reference Kim SH, Ha KI, Kim SH, Choi HJ (2002) Results of arthroscopic treatment of superior labral lesions. J Bone Joint Surg Am 84-A:981–985PubMed Kim SH, Ha KI, Kim SH, Choi HJ (2002) Results of arthroscopic treatment of superior labral lesions. J Bone Joint Surg Am 84-A:981–985PubMed
14.
go back to reference McCulloch PC, Andrews WJ, Alexander J, Brekke A, Duwani S, Noble P (2013) The effect on external rotation of an anchor placed anterior to the biceps in type 2 SLAP repairs in a cadaveric throwing model. Arthroscopy 29:18–24CrossRefPubMed McCulloch PC, Andrews WJ, Alexander J, Brekke A, Duwani S, Noble P (2013) The effect on external rotation of an anchor placed anterior to the biceps in type 2 SLAP repairs in a cadaveric throwing model. Arthroscopy 29:18–24CrossRefPubMed
15.
go back to reference Meserve BB, Cleland JA, Boucher TR (2009) A meta-analysis examining clinical test utility for assessing superior labral anterior posterior lesions. Am J Sports Med 37:2252–2258CrossRefPubMed Meserve BB, Cleland JA, Boucher TR (2009) A meta-analysis examining clinical test utility for assessing superior labral anterior posterior lesions. Am J Sports Med 37:2252–2258CrossRefPubMed
16.
go back to reference Morgan CD, Burkhart SS, Palmeri M, Gillespie M (1998) Type II SLAP lesions: three subtypes and their relationships to superior instability and rotator cuff tears. Arthroscopy 14:553–565CrossRefPubMed Morgan CD, Burkhart SS, Palmeri M, Gillespie M (1998) Type II SLAP lesions: three subtypes and their relationships to superior instability and rotator cuff tears. Arthroscopy 14:553–565CrossRefPubMed
17.
go back to reference Nam EK, Snyder SJ (2003) The diagnosis and treatment of superior labrum, anterior and posterior (SLAP) lesions. Am J Sports Med 31:798–810PubMed Nam EK, Snyder SJ (2003) The diagnosis and treatment of superior labrum, anterior and posterior (SLAP) lesions. Am J Sports Med 31:798–810PubMed
18.
go back to reference Rhee YG, Ha JH (2006) Knot-induced glenoid erosion after arthroscopic fixation for unstable superior labrum anterior–posterior lesion: case report. J Shoulder Elbow Surg 15:391–393CrossRefPubMed Rhee YG, Ha JH (2006) Knot-induced glenoid erosion after arthroscopic fixation for unstable superior labrum anterior–posterior lesion: case report. J Shoulder Elbow Surg 15:391–393CrossRefPubMed
19.
go back to reference Samani JE, Marston SB, Buss DD (2001) Arthroscopic stabilization of type II SLAP lesions using an absorbable tack. Arthroscopy 17:19–24CrossRefPubMed Samani JE, Marston SB, Buss DD (2001) Arthroscopic stabilization of type II SLAP lesions using an absorbable tack. Arthroscopy 17:19–24CrossRefPubMed
20.
go back to reference Silberberg JM, Moya-Angeler J, Martin E, Leyes M, Forriol F (2011) Vertical versus horizontal suture configuration for the repair of isolated type II SLAP lesion through a single anterior portal: a randomized controlled trial. Arthroscopy 27:1605–1613CrossRefPubMed Silberberg JM, Moya-Angeler J, Martin E, Leyes M, Forriol F (2011) Vertical versus horizontal suture configuration for the repair of isolated type II SLAP lesion through a single anterior portal: a randomized controlled trial. Arthroscopy 27:1605–1613CrossRefPubMed
21.
go back to reference Snyder SJ, Karzel RP, Del Pizzo W, Ferkel RD, Friedman MJ (1990) SLAP lesions of the shoulder. Arthroscopy 6:274–279CrossRefPubMed Snyder SJ, Karzel RP, Del Pizzo W, Ferkel RD, Friedman MJ (1990) SLAP lesions of the shoulder. Arthroscopy 6:274–279CrossRefPubMed
22.
go back to reference Yoo JC, Ahn JH, Lee SH, Lim HC, Choi KW, Bae TS, Lee CY (2008) A biomechanical comparison of repair techniques in posterior type II superior labral anterior and posterior (SLAP) lesions. J Shoulder Elbow Surg 17:144–149CrossRefPubMed Yoo JC, Ahn JH, Lee SH, Lim HC, Choi KW, Bae TS, Lee CY (2008) A biomechanical comparison of repair techniques in posterior type II superior labral anterior and posterior (SLAP) lesions. J Shoulder Elbow Surg 17:144–149CrossRefPubMed
23.
go back to reference Yung PS, Fong DT, Kong MF, Lo CK, Fung KY, Ho EP, Chan DK, Chan KM (2008) Arthroscopic repair of isolated type II superior labrum anterior–posterior lesion. Knee Surg Sports Traumatol Arthrosc 16:1151–1157CrossRefPubMed Yung PS, Fong DT, Kong MF, Lo CK, Fung KY, Ho EP, Chan DK, Chan KM (2008) Arthroscopic repair of isolated type II superior labrum anterior–posterior lesion. Knee Surg Sports Traumatol Arthrosc 16:1151–1157CrossRefPubMed
Metadata
Title
Clinical outcome of arthroscopic SLAP repair: conventional vertical knot versus knotless horizontal mattress sutures
Authors
Hyuk Jae Yang
Kisyck Yoon
Hyonki Jin
Hyun Seok Song
Publication date
01-02-2016
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 2/2016
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-014-3449-8

Other articles of this Issue 2/2016

Knee Surgery, Sports Traumatology, Arthroscopy 2/2016 Go to the issue