SLAP Repair Versus Subpectoral Biceps Tenodesis for Isolated SLAP Type 2 Lesions in Overhead Athletes Younger Than 35 Years: Comparison of Minimum 2-Year Outcomes

Lucca Lacheta, Marilee P Horan, Philip C Nolte, Brandon T Goldenberg, Travis J Dekker, Peter J Millett, Lucca Lacheta, Marilee P Horan, Philip C Nolte, Brandon T Goldenberg, Travis J Dekker, Peter J Millett

Abstract

Background: It remains unclear if young overhead athletes with isolated superior labrum anterior-posterior (SLAP) type 2 lesions benefit more from SLAP repair or subpectoral biceps tenodesis.

Purpose: To evaluate clinical outcomes and return to sport in overhead athletes with symptomatic SLAP type 2 lesions who underwent either biceps tenodesis or SLAP repair.

Study design: Cohort study; Level of evidence, 3.

Methods: A retrospective analysis of prospectively collected data was performed in patients who underwent subpectoral biceps tenodesis (n = 14) or SLAP repair (n = 24) for the treatment of isolated type 2 SLAP lesions. All patients were aged <35 years at time of surgery, participated in overhead sports, and were at least 2 years out from surgery. Clinical outcomes were assessed with the American Shoulder and Elbow Surgeons (ASES) score; Single Assessment Numerical Evaluation (SANE) score; Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score; and the 12-Item Short Form (SF-12) physical component score. Return to sport and patient satisfaction were documented. Clinical failures requiring revision surgery and complications were reported.

Results: Preoperative baseline scores in both the tenodesis and SLAP repair groups were similar. There were no significant differences between the groups on any postoperative outcome measure: For biceps tenodesis versus SLAP repair, the ASES score was 92.7 ± 10.4 versus 89.1 ± 16.7, the SANE score was 86.2 ± 13.7 versus 83.0 ± 24.1, the QuickDASH score was 10.0 ± 12.7 versus 9.0 ± 14.3, and SF-12 was 51.2 ± 7.5 versus 52.8 ± 7.7. No group difference in return-to-sports rate (85% vs 79%; P = .640) was noted. More patients in the tenodesis group (80%) reported modifying their sporting/recreational activity postoperatively because of weakness compared with patients in the SLAP repair group (15%; P = .022). One patient in each group progressed to surgery for persistent postoperative stiffness, and 1 patient in the tenodesis group had a postoperative complication related to the index surgery.

Conclusion: Both subpectoral biceps tenodesis and SLAP repair provided excellent clinical results for the treatment of isolated SLAP type 2 lesions, with a high rate of return to overhead sports and a low failure rate, in a young and high-demanding patient cohort. More patients reported modifying their sporting/recreational activity because of weakness after subpectoral tenodesis.

Keywords: SLAP repair; biceps tenodesis; outcomes; superior labrum anterior-posterior (SLAP).

Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: The positions of L.L. and P.C.N. at the Steadman Philippon Research Institute were supported by AGA, via Arthrex, for 1 calendar year. T.J.D. has received educational or grant support from Smith & Nephew, CGG Medical, and DJO. P.J.M. has received research support from Arthrex, Ossur, Siemens, and Smith & Nephew; consulting fees from Arthrex; royalties from Arthrex, Medbridge, and Springer; and hospitality payments from Arthrosurface, Merz Pharmaceuticals, Sanofi-Aventis, and Stryker; and has stock/stock options in VuMedi. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

© The Author(s) 2022.

Figures

Figure 1.
Figure 1.
Right shoulder: viewing via the dorsal standard portal visualizing the final repair construct of a knotless SLAP repair.
Figure 2.
Figure 2.
Right shoulder: view onto the axillary crease with the removed and whipstitched proximal biceps tendon placed on a tenodesis screw for later placement in a unicortical bone tunnel in the humeral shaft.

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Source: PubMed

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