SLAP Repair

A SLAP tear occurs in the top (superior), the front (anterior) and back (posterior) of the point where the biceps tendon attaches to the labrum. The term SLAP is an acronym for Superior Labrum Anterior and Posterior.

SHOULDER ANATOMY

The labrum is a ring of strong, fibrous tissue or cartilage that lines and supports the ball and socket of the shoulder joint. The humeral head, or ball, of the shoulder joint is much larger than the glenoid socket. This creates joint instability. The surrounding labrum serves as a bumper to provide additional stability, and is the attachment site to important ligaments.  The biceps tendon also attaches to the top of the labrum.

CAUSES

A SLAP tear can occur from trauma or overuse. Athletes involved in sports that require repetitive overhead activities are particularly vulnerable to develop this condition. In addition, motor vehicle accidents, falling on an outstretched arm, or forceful pulling on the arm can cause a labral tear. Shoulder dislocations can also cause a tear, often to the front (anterior) or back (posterior).  Further, chronic degenerative fraying of the labrum is commonly seen in patients over the age of 40 years. It often occurs in association with other problems such as rotator cuff tears.

SYMPTOMS

Some of the most common symptoms of a SLAP tear include:

• A feeling of catching, locking, popping, or grinding in the shoulder.

• Pain associated with overhead activities.

• Loss of strength, pain with lifting heavy objects.

• Loss of velocity or control in throwers, “dead arm” feeling.

• Feeling of instability, or true dislocation of the joint

SURGICAL AND NON-SURGICAL TREATMENTS 

For most SLAP tears, conservative management is often effective in alleviating symptoms and improving function. Anti-inflammatory medication and periodic icing may help alleviate some of the symptoms. Following diagnosis, your physician may prescribe rehabilitation exercises to strengthen the rotator cuff and correct shoulder blade mechanics.

If you continue to experience symptoms despite conservative management, your orthopedist may recommend surgery.  A SLAP repair is a minimally invasive arthroscopic procedure which uses a tiny camera and miniature surgical instruments to repair the damaged area. During the procedure, your surgeon will remove damaged tissue. Then, he or she will suture the torn labrum to a tiny anchor set into the bone. In some cases, your surgeon will perform a biceps tenodesis procedure to release the biceps tendon from the torn labrum. He or she will reattach it lower down on the humerus bone.

You can watch the video below for a general demonstrates the procedure. However a patient’s surgery may vary depending on the individual’s unique anatomy.

Schedule an appointment with an ONS orthopedic shoulder specialist or call (203) 869-1145.