Shoulder

SLAP Tear

SLAP (Superior Labrum Anterior Posterior) is an injury to the labrum of the shoulder, which is the ring of cartilage that surrounds the socket of the shoulder joint. Most often an injury among athletes and physically active people. There are many types of such an injury.

SLAP types:

  • I – the edges of the labrum are rough and fray along the free margin, but the labrum is not completely detached.
  • II – in 50% of cases a completely torn off glenoid
  • III – a ‘bucket-handle tear’ of the labrum
  • IV – a ‘bucket-handle tear’ of the labrum extends into the long head of the biceps

Symptoms

  • Injuries to the labrum type of SLAP are the result of multiple repetition of certain actions or acute injury;
  •  SLAP damage primarily occurs among athletes performing any forms of throw;
  •  Shoulder pain with lifting objects especially overhead
  • A feeling that the shoulder is going to pop out of joint;
  • A stabbing pain associated with the loss of control of limbs during maximal external rotation combined with abduction;
  • Most of the damage associated with other types of SLAP lesions: rotator cuff tear or instability of the joint. SLAP is difficult to diagnose with just one test. A magnetic resonance and X-ray should be performed, which help to exclude additional pathologies associated with bone tissue.

Treatment

Treatment of SLAP lesions depends on the type of diagnosis, whether there was a detachment of the the biceps or upper part of the anterior labrum. In case of damage of type I and III part of the labrum is cleaned without the need of stitching. Type II repair consists of arthroscopic suturing and fixing the fragment using special implants. SLAP type IV often demands sewing and stitching of the muscle labrum.

Recovery

The rehabilitation program after surgery mainly depends on the size of surgical intervention in the repair of the attachment of the tendon of the biceps.

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