Abstract
Aim: The detachment of superior glenoid labrum extending anterior and posterior (SLAP) is a traumatic condition which is just recently recognized as an important source of shoulder pain and dysfunction. This lesion can occur isolated or in association with other pathologic entities such as: impingement syndrome, rotator cuff ruptures and instability. The diagnosis with clinical examination, simple x-rays and MRI is difficult and it can be established only arthroscopicaly. The aim of this study is to present the technique and the results of the arthroscopic labral reattachment and also to point out the necessity of treatment especially in the coexistence with other pathologies.
Method: 7 patients with SLAP type II were arthroscopicaly operated. There were 6 males and 1 female aged from 31 to 52 years. 4 patients had an associated rotator cuff partial rupture and 2, had a Bankart lesion with anterior instability. Arthroscopy was performed under general anesthesia with the patients in the beach chair position. We used the standard posterior and anterior portals and also a third superior-anterior. We used VAPR and shaver for preparation and slight decortication of superior glenoid. With a special curved needle we passed a suture PDS NoI from the superior anterior labrum then through a Mitek GII anchor which we place after predriling at the superior glenoid. The Ethibon suture of the anchor was passed through the posterior superior labrum. We used arthroscopic knots to tie down the sutures. Finally the superior labrum is stabilized with 2 sutures in V configuration through a singular Mitek GII anchor anterior and posterior the anchor of biceps. Postoperative care depended on coexisting lesions. Most of the patients had their shoulder immobilized for 3 weeks in a sling.
Results: The average follow up was 18 months (12–22). All patients had complete resolution of the preoperative pain. 5 patients had full range of movements and no functional restriction. The remaining 2 patients had a slight restriction of movements mainly in internal rotation. All patients had normal muscle strength and all had constant score above 80.
Conclusion: Stabilization of the superior labrum with the described technique is successful and effective for type II SLAP lesion treatment. We believe that arthroscopic examination of the shoulder should be done even before an open shoulder surgery for other pathologies. Arthroscopy is the only way to detect a coexisting SLAP lesion and repair it, otherwise it may negatively influence the success of the operation.
The abstracts were prepared by Eleni Koutsoukou. Correspondence should be addressed to him at the Hellenic Association of Orthopaedic Surgery and Traumatology (HAOST), 20, A. Fleming str, 15123 Marousi, Athens, Greece.
