RESEARCH ARTICLE
An Age and Activity Algorithm for Treatment of Type II SLAP Tears
Michael D. Charles, David R. Christian, Brian J. Cole*
Article Information
Identifiers and Pagination:
Year: 2018Volume: 12
Issue: Suppl-1, M2
First Page: 271
Last Page: 281
Publisher ID: TOORTHJ-12-271
DOI: 10.2174/1874325001812010271
Article History:
Received Date: 28/3/2018Revision Received Date: 24/4/2018
Acceptance Date: 24/5/2018
Electronic publication date: 31/7/2018
Collection year: 2018
open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: (https://creativecommons.org/licenses/by/4.0/legalcode). This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Background:
Type II SLAP tears predominantly occur in males between their third and fifth decades of life. The mechanism of injury is often repeated overheard activity but can also occur due to direct compression loads and traction injuries. The treatment options have changed over the years and include non-operative therapy, direct labral-biceps complex repair, and labral debridement with biceps tenodesis or tenotomy.
Objective:
To review the existing literature on the management of Type II SLAP tears and provide clinical recommendations based on patient age and activity level.
Methods:
A review of the existing literature through October 2017 investigating the management of Type II SLAP tears was performed. Emphasis was placed on distinguishing the outcomes based on age and activity level to provide an appropriate treatment algorithm.
Results:
Patients with Type II SLAP tears should first be trialed with non-operative management and many patients will have a successful result with ability to return to their respective sports or activities. Surgical management should be considered if non-operative management does not provide symptomatic relief. Young, athletic, or high-demand patients should be treated with a SLAP repair while biceps tenodesis should be considered for older or worker’s compensation patients. Patients undergoing revision surgery for a failed SLAP repair should be managed with biceps tenodesis.
Conclusion:
Type II SLAP tears remain a difficult pathology to manage clinically, but the treatment indications are narrowing. The age and activity algorithm described in this review provides an effective method of managing this complex clinical condition.