171 – INDICATIONS FOR SLAP TYPE II REPAIRS: IMPACT OF AGE AND ASSOCIATED PATHOLOGY ON CLINICAL OUTCOMES

Abstract

Purpose: The purposes of this study were to examine factors that influenced the decision to repair a SLAP Type II lesion and to examine the difference between patients with and without a SLAP repair.

Method: Prospectively collected data of patients who had a SLAP Type II lesion were reviewed. Patients who had a repair were compared with those who did not have a clinical indication for repair. Disability outcome measures collected pre and 2 years post-operatively were the American Shoulder and Elbow Surgeons (ASES) and the Constant-Murley scores (CMS). Paired and independent t-tests and logistic regression were performed.

Results: One hundred and six patients (83 males, 23 females), mean age=50 (SD=14, range 18–81), with a SLAP Type II lesion were identified. Eleven patients (10%) had isolated SLAP pathology for which they received a repair. The remaining 95 (90%) patients had concurrent pathologies related to rotator cuff, instability, osteoarthritis, and other pathologies. Repair of the SLAP lesion was felt to be clinically indicated in 43(45%) of patients with combined lesions. Factors that influenced the decision to repair the SLAP lesion were age, nature of the associated pathology, the presence of a large or massive full thickness rotator cuff tear, anterior instability, and a partial biceps tear greater than 50% that required a tenodesis. Significant improvement was observed in the ASES and CMS scores (p < 0.0001) whether or not a SLAP repair was performed.

Conclusion: This study indicates that age and presence of certain associated pathologies influence the need for SLAP Type II repair. A statistically significant improvement in strength and disability level is observed in patients with SLAP Type II lesions associated with concomitant pathology, despite not having the SLAP lesion repaired. The indications for SLAP Type II repair in the presence of other pathologies are discussed.