SLAP Repair

Dr. Frank Cannon

Dr. Frank Cannon

Dr. Frank Cannon is a Board Certified Orthopedic Surgeon that specializes in treating patients that have knee, shoulder, and hip problems.

What is SLAP repair?

SLAP is a medical term that refers to the superior labrum anterior and posterior. The labrum is a ring of cartilage that circles the ball and socket joint of the shoulder, further expanding the depth of the glenoid fossa which allows for increased range of motion in the shoulder. SLAP injuries occur when the upper portion of the labrum succumbs to injury, typically in the region where the biceps tendon connects to the labrum. When an individual suffers a SLAP tear, it affects both the anterior and posterior of this connection. It can also affect the bicep tendon itself, which means a SLAP injury can be greatly debilitating if left untreated.

Who is a Candidate?

If conservative treatment methods, such as nonsteroidal anti-inflammatory medication and physical therapy, fail to relieve an individual’s pain from a SLAP tear, surgery is commonly used to provide relief. Acute trauma and repetitive shoulder motion are the two most common causes of SLAP injury. Acute SLAP injuries can result from any number of factors; however, the most common causes are:

  • Motor vehicle accidents
  • Any incident in which an individual falls onto their outstretched arm
  • Situations where the arm is pulled with great force, including lifting or catching heavy object
  • Dislocation of the shoulder
  • Moving the arm rapidly or with excessive force when it is raised above shoulder level

Repetitive shoulder motion SLAP injuries are commonly linked with sports and physical occupations. Weightlifters, athletes, construction professionals, and others who engage in regular physical activity are at an increased risk of SLAP injury. However, this isn’t intended to suggest that these types of people are the only ones who may injure their labrum.

SLAP tears can also occur naturally over time as the labrum is worn down. During your thirties and forties, it’s not uncommon for small tears to form in the superior labrum. While this form of SLAP injury is drastically different from an acute injury, the end result — pain, numbness, limited range of motion — is virtually the same.

The only surefire way to identify a SLAP tear is to report any symptoms you are experiencing to your medical provider so they can perform a diagnostic. Common symptoms of a SLAP tear include:

  • Pain when moving the shoulder or lifting heavy objects overhead
  • Noticeable locking or catching in the shoulder
  • A Popping and grinding sensation during certain movements
  • Weakened strength in the shoulder
  • A feeling of looseness in the joint
  • Limited range of motion
  • “Dead arm” after vigorous activity

Anyone experiencing one or more of the above symptoms could be a potential candidate for SLAP repair. An examination of a person’s medical history, a physical exam, and one or more imaging tests (i.e., x-rays, MRI scans) can determine whether or not SLAP repair is the right treatment option.

What Happens During the Procedure?

SLAP REPAIRSLAP repair is a type of arthroscopic surgery that can be performed under general or regional anesthesia. Like most arthroscopic procedures, SLAP repair can be performed without opening a large wound on the patient, instead relying on several small incisions that allow the orthopedic surgeon to insert a tiny, tube-like camera (arthroscope) into the patient without significant discomfort. Once the arthroscope has been fished through the incision, the orthopedic surgeon will position it in a way that provides the optimum visual acuity of the surgical site. At this time, the surgeon may discover additional signs of injury, such as inflammation, ligament tears, and damaged cartilage, indicating that further treatment is required.

SLAP Repair surgeryWhen the orthopedic surgeon is ready, they will enter the surgical site using the visual sent from the arthroscope to the monitor as a guide. First, any extraneous or damaged tissue is trimmed away using arthroscopic instruments. Then, a hole drilled into the bone and an anchor point is attached. A durable suture is connected to the anchor point, which is used to tie the labrum to the bone in its original location. Finally, the orthopedic surgeon inserts additional anchors to ensure that the torn labrum is fixed in place. Once the procedure is complete, all of the instruments are removed and the incisions are closed. Voila! The torn labrum is officially on the road to recovery.

What are the Risks?

Undergoing surgery to repair a SLAP tear is a big decision, but with advanced, minimally invasive treatment options available, patients are finding relief for their shoulder pain without extended hospitalizations or serious complications. In fact, a study of 102 patients undergoing SLAP repair yielded a 97% “rate of good or excellent outcomes at one year after surgery.”

Most patients do not experience complications during or after SLAP repair; however, complications can arise from time to time. SLAP repair complications may include infection, excessive blood loss, blood clots, shoulder stiffness, and nerve damage. Some patients may be at a higher risk for certain complications.

How is the Recovery Process?

Returning to full activity following surgery takes time, patience, and rehabilitation. Athletes are especially susceptible to re-aggravating an injured labrum as they rush to return to the stadium. Be patient. The recovery process following SLAP repair can take as long as six months or more depending on the age and health of the patient, and everyone will have a different experience during recovery. Expect to wear a sling for a month or more following surgery. Once the shoulder can be moved and inflammation has receded, physical therapy can begin. The key is to restore flexibility to the shoulder while gradually increasing its strength. Over the next six to ten weeks, physical therapy will assist the natural healing process. Those who plan to return to competitive athletics or rigorous physical activity or work should consult their orthopedic surgeon to get the final “go ahead.”

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Dr. Frank Cannon

Board Certified Orthopedic Surgeon

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