Your shoulder joint is a ball and socket joint made up of the upper arm bone, the shoulder blade and the collarbone. The head of the upper arm bone fits into the socket of the shoulder joint known as the glenoid cavity. The outer edge of the glenoid is surrounded by a strong fibrous tissue called the labrum.
What is a SLAP Tear?
A superior labrum anterior and posterior tear or SLAP tear is an injury to the labrum. This injury may also involve the biceps tendon, which is attached to the top part of the labrum. The injury occurs from repeated use of the shoulder while throwing or a fall onto the shoulder. A SLAP tear can be treated through an arthroscopic surgical procedure called a SLAP repair.
Indications for SLAP Repair
A SLAP repair is indicated to treat the torn labrum of the shoulder socket when conservative treatment measures such as NSAID’s (non-steroidal anti-inflammatory medications) and physical therapy do not relieve the symptoms of a SLAP tear.
How is a SLAP Repair performed?
A SLAP repair is a minimally invasive surgery using an arthroscope, a tube with a light and camera on the end that projects images onto a monitor for your surgeon to view inside your joint. The type of SLAP repair depends on the type of tear involved and will be determined once your surgeon views the joint. The procedure is performed under general anaesthesia and nerve block.
- Your surgeon first makes small incisions to insert the arthroscope and thin surgical instruments into the shoulder joint.
- Your surgeon will then identify the type of SLAP tear and remove the damaged tissue of the labrum.
- A small hole is then drilled into the bone of the shoulder socket close to the labral tear.
- Your surgeon will place an anchor into the drilled hole along with a strong suture.
- Additional anchors can be placed as required for securing the torn labrum to the bone of the shoulder socket.
- Finally, the torn labrum is tied to the bone with the sutures.
Postoperative Care Following SLAP Repair
After the procedure, your arm will be placed in a sling for the first 3 weeks to immobilise the shoulder joint and you will be advised to restrict active motion of your shoulder for about 6 weeks. You will be instructed take your pain medications and to apply ice packs to control swelling and pain. The plaster strips over the wounds should be kept dry until the wounds heal. Through physical therapy, you can slowly regain motion and strengthen the shoulder. You can resume sports activities after consulting with your physical therapist and surgeon. You should avoid driving for a few weeks after the surgery.
Advantages of SLAP Repair
A SLAP repair involves the reattaching of the labrum to its normal anatomical position; thereby restoring the anatomy of the shoulder. The procedure also allows normal functioning of the previously damaged labrum and biceps attachment.
Risks Associated with SLAP Repair
As with any surgical procedure, SLAP repair involves certain potential risks and complications including
- Excessive bleeding
- Blood clots
- Shoulder stiffness
- Injury to nerves or blood vessels
Arthroscopy is a minimally invasive diagnostic and surgical procedure performed for joint problems. Shoulder arthroscopy is performed using a pencil-sized instrument called an arthroscope. The arthroscope consists of a light system and camera to project images to a computer screen for your surgeon to view the surgical site. Arthroscopy is used to treat disease conditions and injuries involving the bones, cartilage, tendons, ligaments, and muscles of the shoulder joint.
The shoulder joint is a ball and socket joint. A 'ball' at the top of the upper arm bone (the humerus) fits neatly into a 'socket', called the glenoid, which is part of the shoulder blade (scapula). The term SLAP (superior –labrum anterior-posterior) lesion or SLAP tear refers to an injury of the superior labrum of the shoulder.
Proximal Biceps Tenodesis is the surgical reattachment of a torn proximal biceps tendon, which connects the upper part of your biceps muscle to the shoulder.