Skip to main content
Top
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 12/2008

01-12-2008 | Shoulder

Arthroscopic repair of isolated type II superior labrum anterior–posterior lesion

Authors: Patrick Shu-Hang Yung, Daniel Tik-Pui Fong, Ming-Fat Kong, Chun-Kong Lo, Kwai-Yau Fung, Eric Po-Yan Ho, Derwin King-Chung Chan, Kai-Ming Chan

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 12/2008

Login to get access

Abstract

The effectiveness of arthroscopic repair of type II superior labrum anterior–posterior lesion (SLAP) was unclear as previous studies examined this treatment with patients of combined types of SLAP lesions. To address this research gap, we evaluated the clinical and functional outcomes of arthroscopic repair for 16 patients (mean = 24.2, SD = 6.5) with clinical evidence of isolated type II SLAP lesion. After having arthroscopic stabilizations with Bioknotless suture anchors (Mitek), the patients were offered post-operative rehabilitation programs (e.g., physiotherapy) for 6 months. The symptoms of SLAP lesion and the functions of the shoulder were assessed pre-operatively and 28-month post-operatively by O’Brien test, Speed test, Yergason test, and University of California at Los Angeles rating for pain and function of the shoulder. Wilcoxon Signed Ranks test and McNemar test were employed to analyze the difference between assessment in pre-operation and post-operation phases. The result showed that patients’ shoulder functions improved (UCLA Shoulder Score), and symptoms of SLAP lesion reduced (O’Brien test, Speed test, and Yergason test) significantly (P < 0.05). Time for returning to play with pre-injury level was in average 9.4 months (range 4–24), and no complication or recurrence was detected. We concluded that arthroscopic repair is an effective operation of type II SLAP lesion with good clinical and functional outcomes; however, athletes with high demand of overhead throwing activities are likely to take longer duration of rehabilitation to attain full recovery.
Literature
1.
go back to reference Altchek DW, Warren RF, Wickiewicz TL (1992) Arthroscopic labral debridement. A three-year follow-up study American. J Sports Med 20(6):702–706CrossRef Altchek DW, Warren RF, Wickiewicz TL (1992) Arthroscopic labral debridement. A three-year follow-up study American. J Sports Med 20(6):702–706CrossRef
2.
go back to reference Andrews JR, Carson WG Jr, McLeod WD (1985) Glenoid labrum tears related to the long head of the biceps. Am J Sports Med 13(5):337–341PubMedCrossRef Andrews JR, Carson WG Jr, McLeod WD (1985) Glenoid labrum tears related to the long head of the biceps. Am J Sports Med 13(5):337–341PubMedCrossRef
3.
go back to reference Burkart A, Imhoff AB, Roscher E (2000) Foreign-body reaction to the bioabsorbable suretac device. Arthroscopy 16(1):91–95PubMed Burkart A, Imhoff AB, Roscher E (2000) Foreign-body reaction to the bioabsorbable suretac device. Arthroscopy 16(1):91–95PubMed
4.
go back to reference Burkhart SS, Morgan CD, Kibler WB (2000) Shoulder injuries in overhead athletes. The “dead arm” revisited clinics in sports. Medicine 19(1):125–158 Burkhart SS, Morgan CD, Kibler WB (2000) Shoulder injuries in overhead athletes. The “dead arm” revisited clinics in sports. Medicine 19(1):125–158
5.
go back to reference Burkhart SS, Morgan CD, Kibler WB (2000) The disable throwing shoulder: spectrum of pathology part I: Pathoanatomy and biomechanics. Arthroscopy 19(4):404–420 Burkhart SS, Morgan CD, Kibler WB (2000) The disable throwing shoulder: spectrum of pathology part I: Pathoanatomy and biomechanics. Arthroscopy 19(4):404–420
6.
go back to reference Cordasco FA, Steinmann S, Flatow EL (1993) Arthroscopic treatment of glenoid labral tears. Am J Sports Med 21(3):425–431PubMedCrossRef Cordasco FA, Steinmann S, Flatow EL (1993) Arthroscopic treatment of glenoid labral tears. Am J Sports Med 21(3):425–431PubMedCrossRef
7.
go back to reference Ellman H, Hanker G, Bayer M (1986) Repair of the rotator cuff. End-result study of factors influencing reconstruction. J Bone Joint Surg Am 68(8):1136–1144PubMed Ellman H, Hanker G, Bayer M (1986) Repair of the rotator cuff. End-result study of factors influencing reconstruction. J Bone Joint Surg Am 68(8):1136–1144PubMed
8.
go back to reference Field LD, Savoie FH 3rd (1993) Arthroscopic suture repair of superior labral detachment lesions of the shoulder. Am J Sports Med 21(6):783–790 discussion 790PubMedCrossRef Field LD, Savoie FH 3rd (1993) Arthroscopic suture repair of superior labral detachment lesions of the shoulder. Am J Sports Med 21(6):783–790 discussion 790PubMedCrossRef
9.
go back to reference Gilecreest EL, Albi P (1939) Unusual lesions of muscles and tendons of the shoulder girdle and upper arm. Surg Gynecol Obstet 68:903–917 Gilecreest EL, Albi P (1939) Unusual lesions of muscles and tendons of the shoulder girdle and upper arm. Surg Gynecol Obstet 68:903–917
10.
go back to reference Holtby R, Razmjou H (2004) Accuracy of the speed’s and Yergason’s tests in detecting biceps pathology and SLAP lesions: comparison with arthroscopic findings. J Arthrosc Relat Surg 20(3):231–236CrossRef Holtby R, Razmjou H (2004) Accuracy of the speed’s and Yergason’s tests in detecting biceps pathology and SLAP lesions: comparison with arthroscopic findings. J Arthrosc Relat Surg 20(3):231–236CrossRef
11.
go back to reference Kim SH, Ha KI, Kim SH et al (2002) Results of arthroscopic treatment of superior labral lesions. J Bone Joint Surg Am 84-A(6):981–985PubMed Kim SH, Ha KI, Kim SH et al (2002) Results of arthroscopic treatment of superior labral lesions. J Bone Joint Surg Am 84-A(6):981–985PubMed
12.
go back to reference Law BKY, Yung PSH, Ho PY, Chang JJ, Chan KM (2008) The surgical outcome of immediate arthroscopic Bankart repair for first time anterior shoulder dislocation in young active patients. Knee Surg Sports Traumatol Arthrosc 16:188–193PubMedCrossRef Law BKY, Yung PSH, Ho PY, Chang JJ, Chan KM (2008) The surgical outcome of immediate arthroscopic Bankart repair for first time anterior shoulder dislocation in young active patients. Knee Surg Sports Traumatol Arthrosc 16:188–193PubMedCrossRef
13.
go back to reference Maffet MW, Gartsman GM, Moseley B (1995) Superior labrum-biceps tendon complex lesions of the shoulder. Am J Sports Med 23(1):93–98PubMedCrossRef Maffet MW, Gartsman GM, Moseley B (1995) Superior labrum-biceps tendon complex lesions of the shoulder. Am J Sports Med 23(1):93–98PubMedCrossRef
14.
go back to reference Mohana-Borges AVR, Chung CB, Resnick D (2003) Superior labral anteroposterior tear: classification and diagnosis on MRI and MR arthrography. Am J Roentgenol 181:1449–1462 Mohana-Borges AVR, Chung CB, Resnick D (2003) Superior labral anteroposterior tear: classification and diagnosis on MRI and MR arthrography. Am J Roentgenol 181:1449–1462
15.
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 14:553–565PubMed 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 14:553–565PubMed
16.
go back to reference O’Brien SJ, Allen AA, Coleman SH (2002) The trans-rotator cuff approach to SLAP lesions: technical aspects for repair and a clinical follow-up of 31 patients at a minimum of 2 years. Arthroscopy 18(4):372–377PubMed O’Brien SJ, Allen AA, Coleman SH (2002) The trans-rotator cuff approach to SLAP lesions: technical aspects for repair and a clinical follow-up of 31 patients at a minimum of 2 years. Arthroscopy 18(4):372–377PubMed
17.
go back to reference Resch H, Golser K, Theoni H (1993) Arthroscopic repair of superior glenoid labral detachment (the SLAP lesion). J Shoulder Elbow Surg 2(3):147–155CrossRef Resch H, Golser K, Theoni H (1993) Arthroscopic repair of superior glenoid labral detachment (the SLAP lesion). J Shoulder Elbow Surg 2(3):147–155CrossRef
18.
go back to reference Resnick D (1997) Shoulder. In: Resnick D, Kang HS (eds) Internal derangements of joints: emphasis on MR imaging. Saunders, Philadelphia, pp 71–281 Resnick D (1997) Shoulder. In: Resnick D, Kang HS (eds) Internal derangements of joints: emphasis on MR imaging. Saunders, Philadelphia, pp 71–281
19.
go back to reference Rhee YG, Lee DH, Lim CT (2005) Unstable isolated SLAP lesion: clinical presentation and outcome of arthroscopic fixation. Arthroscopy 21(9):1099PubMed Rhee YG, Lee DH, Lim CT (2005) Unstable isolated SLAP lesion: clinical presentation and outcome of arthroscopic fixation. Arthroscopy 21(9):1099PubMed
20.
go back to reference Segmuller HE, Hayes MG, Saies AD (1997) Arthroscopic repair of glenolabral injuries with an absorbable fixation device. J Shoulder Elbow Surg 6(4):383–392PubMedCrossRef Segmuller HE, Hayes MG, Saies AD (1997) Arthroscopic repair of glenolabral injuries with an absorbable fixation device. J Shoulder Elbow Surg 6(4):383–392PubMedCrossRef
21.
go back to reference Snyder SJ, Banas MP, Karzel RP (1995) An analysis of 140 injuries to the superior glenoid labrum. J Shoulder Elbow Surg 4(4):243–248PubMedCrossRef Snyder SJ, Banas MP, Karzel RP (1995) An analysis of 140 injuries to the superior glenoid labrum. J Shoulder Elbow Surg 4(4):243–248PubMedCrossRef
22.
go back to reference Snyder SJ, Karzel RP, Del Pizzo W (1990) SLAP lesions of the shoulder. Arthroscopy 6(4):274–279PubMed Snyder SJ, Karzel RP, Del Pizzo W (1990) SLAP lesions of the shoulder. Arthroscopy 6(4):274–279PubMed
23.
go back to reference Speer KP, Warren RF, Pagnani M (1996) An arthroscopic technique for anterior stabilization of the shoulder with a bioabsorbable tack. J Bone Joint Surg Am 78(12):1801–1807PubMed Speer KP, Warren RF, Pagnani M (1996) An arthroscopic technique for anterior stabilization of the shoulder with a bioabsorbable tack. J Bone Joint Surg Am 78(12):1801–1807PubMed
24.
go back to reference Thal R (2001) A Knotless Suture Anchor: technique for use in arthroscopic Bankart repair. Arthroscopy 17(2):213–218PubMedCrossRef Thal R (2001) A Knotless Suture Anchor: technique for use in arthroscopic Bankart repair. Arthroscopy 17(2):213–218PubMedCrossRef
25.
go back to reference Warner JJ, Kann S, Marks P (1994) Arthroscopic repair of combined Bankart and superior labral detachment anterior and posterior lesions: technique and preliminary results. Arthroscopy 10(4):383–391PubMed Warner JJ, Kann S, Marks P (1994) Arthroscopic repair of combined Bankart and superior labral detachment anterior and posterior lesions: technique and preliminary results. Arthroscopy 10(4):383–391PubMed
26.
go back to reference Yergason RM (1931) Supination sign. J Bone Joint Surg 13:160 Yergason RM (1931) Supination sign. J Bone Joint Surg 13:160
27.
go back to reference Yoneda M, Hirooka A, Saito S (1991) Arthroscopic stapling for detached superior glenoid labrum. J Bone Joint Surg Br 73(5):746–750PubMed Yoneda M, Hirooka A, Saito S (1991) Arthroscopic stapling for detached superior glenoid labrum. J Bone Joint Surg Br 73(5):746–750PubMed
28.
go back to reference Zuckerman JD, Matsen FA 3rd (1984) Complications about the glenohumeral joint related to the use of screws and staples. J Bone Joint Surg Am 66(2):175–180PubMed Zuckerman JD, Matsen FA 3rd (1984) Complications about the glenohumeral joint related to the use of screws and staples. J Bone Joint Surg Am 66(2):175–180PubMed
Metadata
Title
Arthroscopic repair of isolated type II superior labrum anterior–posterior lesion
Authors
Patrick Shu-Hang Yung
Daniel Tik-Pui Fong
Ming-Fat Kong
Chun-Kong Lo
Kwai-Yau Fung
Eric Po-Yan Ho
Derwin King-Chung Chan
Kai-Ming Chan
Publication date
01-12-2008
Publisher
Springer-Verlag
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 12/2008
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-008-0629-4

Other articles of this Issue 12/2008

Knee Surgery, Sports Traumatology, Arthroscopy 12/2008 Go to the issue