What Is The Difference Between Tenodesis And Slap Repair

J Orthop Translat. 2022 January; xvi: 23–32.

Effectiveness of biceps tenodesis versus SLAP repair for surgical treatment of isolated SLAP lesions: A systemic review and meta-assay

Min Li

^aSection of Orthopaedic Surgery, Shenzhen Hospital, Southern Medical University, Shenzhen, People's republic of china

Atik Badshah Shaikh

^bInquiry & evolution constitute in Shenzhen, Research & Development Institute in Shenzhen, Northwestern Polytechnical University, Shenzhen, Guangdong, China

^cConstitute of Special Environmental Biophysics, Key Laboratory for Space Bioscience and Biotechnology, Institute of Special Environmental Biophysics, Schoolhouse of Life Sciences, Northwestern Polytechnical University, Xi'an, Shanxi, China

Jinbo Dominicus

^dDepartment of Sports Medicine, Xingyi People's Infirmary, Guizhou Medical University, Guizhou, China

Peng Shang

^bResearch & development institute in Shenzhen, Research & Development Institute in Shenzhen, Northwestern Polytechnical University, Shenzhen, Guangdong, China

^cInstitute of Special Environmental Biophysics, Key Laboratory for Space Bioscience and Biotechnology, Institute of Special Environmental Biophysics, Schoolhouse of Life Sciences, Northwestern Polytechnical Academy, Xi'an, Shanxi, Cathay

Xiliang Shang

^eDepartment of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China

Received 2022 May 6; Revised 2022 Aug 22; Accepted 2022 Sep 7.

Abstract

Background

Blazon II superior labrum anterior and posterior (SLAP) lesions could induce chronic shoulder pain and dumb motility. Current management of Blazon II SLAP lesions consists of two well-established surgical procedures: arthroscopic biceps tenodesis and SLAP repair. All the same, which technique is preferred over the other is still a controversy.

Methods

We performed a systematic electronic database search on Cochrane Central Register of Controlled Trials, MEDLINE and Embase to identify articles equating superior labral repair with biceps tenodesis, which were reported earlier August 2022 which included the phrase "superior labral inductive posterior" or "SLAP." The randomised controlled clinical trials that met our criteria were evaluated for quality of methodology. The results obtained were further analysed and correlated to nowadays the benefits and drawbacks comparing the ii SLAP repair surgical procedures.

Effect

Based on our inclusion and exclusion criteria, we identified five articles (204 patients) that were included in this meta-analysis. The results indicate that prevalence of patients return to preinjury sports level and the patients satisfaction were constitute to be significantly improve in tenodesis grouping than in the SLAP repair group (p < 0.05). As for the patient age, VAS score, American Shoulder and Elbow Surgeons score, University of California at Los Angeles score, postoperative stiffness and reoperation rates, no significant differences were axiomatic among the two groups, thus supporting the results reported in the current literatures (p > 0.05).

Conclusions

Both the surgical treatments, SLAP repair and the biceps tenodesis, are efficacious in pain alleviation and recovery of shoulder part. Only, compared with SLAP repair, biceps tenodesis showed college charge per unit of patient satisfaction and render to preinjury sports participation.

The translational potential of this article

Impart better understanding regarding discrepancies in the outcomes betwixt biceps tenodesis and SLAP repair in treating patients with isolated Type 2 SLAP lesions.

Keywords: Labral repair, Superior labrum anterior and posterior, Tenodesis

Abbreviations: ASES, American Shoulder and Elbow Surgeons score; CMS, Coleman methodology score; SLAP, superior labrum anterior and posterior; UCLA, University of California at Los Angeles score; VAS, Visual Analogue Scale score; LOE, Level of testify

Introduction

The superior labrum anterior and posterior (SLAP) lesions were primarily reported by Andrews et al [1] in 1985. Afterwards, Snyder et al [two] classified these labral tears into 4 subtypes. Among the four types, Blazon Two SLAP lesion is predominantly clinically nigh encountered, and it is elucidated from other types by detachment of the superior labrum and biceps anchor from the superior glenoid [3]. Type II SLAP lesion can cause chronic shoulder pain and dysfunction. Electric current conservative direction for Type II SLAP lesion includes action modification, non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroid injection, whereas patients with symptomatic Blazon II SLAP lesion in whom conservative treatment failed ofttimes undergo surgical treatment. Present surgical treatment generally consists of either arthroscopic superior labral repair or biceps tenodesis.

Several studies have reported that arthroscopic SLAP repair for Type II SLAP lesions could receive significant clinical or functional improvement. For example, Brockmeier et al [iv] performed SLAP repair on Blazon II SLAP lesion patients with an average follow-upward period of 2.7 years, and forty-ane patients (87%) reported the upshot as adept or excellent. Similarly, Boesmueller et al [v] found that arthroscopic SLAP repair resulted in adequate functional outcomes, and one-half of the patients involved in competitive sports activeness were able to return to their preinjury sports levels half-dozen months afterward surgery.

However, recently, some studies take found that SLAP repair was non every bit successful as originally reported and was associated with postoperative stiffness, continued pain, lower rates of return to activity and failure of the labrum to heal to the superior glenoid [6]. For case, Provencher et al [7] evaluated 179 Blazon Ii SLAP repairs and constitute that 66 patients (37%) met failure criteria, and fifty patients (28%) elected revision surgery. Waterman et al reported a failure in 13% (due north = 31) of patients with SLAP repair, of whom six patients required revision SLAP repair and 25 patients underwent subpectoral biceps tenodesis. They demonstrated that majority of patients who underwent biceps tenodesis (76%) returned to agile duty equally compared with those who underwent revision SLAP repair (17%) [8].

In view of the findings in the aforementioned studies, as an alternative to SLAP repairs, biceps tenodesis has been the favoured surgical handling for nonathletic patients. Some advantages of biceps tenodesis over SLAP repair may include less postoperative stiffness, college rates of return to activity and amend patient satisfaction. Boileau et al [9] compared the two surgical procedures and showed that thirteen patients (87%) were able to recover to initial sports level participation afterwards biceps tenodesis compared with merely xx% (2 of x) after SLAP repair (p = 0.01). Despite several reports, surgical direction of Type Two SLAP lesions is all the same disputed equally there are several factors that could affect the surgical outcome, such as historic period, action level, quality of the labral tissue and concomitant pathology [7], [10], [eleven], [12], [thirteen]. Besides, in that location is no meta-analysis that compares the functional results amidst patients undergoing superior labral repair or biceps tenodesis of the isolated Type Two SLAP lesions right now. Therefore, the scope of this meta-analysis is to determine whether there are discrepancies in the outcomes between biceps tenodesis and SLAP repair in treating patients with isolated Blazon 2 SLAP lesions.

Materials and methods

Search strategy

We carried out a meta-analysis of the literature with the search terms "superior labral inductive posterior" or "SLAP". A complete search of the literature in the post-obit databases was performed: MEDLINE (PubMed) (1950 to August 2022), Embase (Ovid) (1974 to August 2022) and Cochrane (1996 to August 2022). Our inclusion criteria included outcome-based studies of isolated Type II SLAP lesions which compared superior labral repair and biceps tenodesis past using clinical or functional scoring systems. Exclusion criteria included studies that involved cadaver or animal studies, biomechanical studies, literature reviews, letters to editors, expert opinion articles, case reports or technique notes which did non contain clinical effect-based data.

Quality cess

The Coleman methodology score (CMS) was applied to determine the quality of the involved studies. The CMS consists of 15 items in its checklist and is scaled from 0 to 100 points. A score from 85 to 100 is considered splendid, 70–84 as skillful, 55–69 every bit fair and below 55 as poor. An overall score of 100 suggests that the report avoids risk, bias and misreckoning variables. The quality assessment by CMS was carried out by two contained reviewers (i orthopaedic resident and one shoulder fellow). In addition, all the results were confirmed by the senior author.

Outcome measures

The identified studies were measured and analysed for the following outcomes: patient age, return to previous sport level, reoperation, patient satisfaction, University of California at Los Angeles (UCLA) score, American Shoulder and Elbow Surgeons (ASES) score, visual analogue calibration (VAS) score and postoperative stiffness. Two reviewers evaluated the literature separately, and any discrepancies were reevaluated and resolved by consensus.

Statistical analysis

A formal meta-analysis was conducted only for clinical outcome data from comparative studies using Stata 12.0 (Stata Corp LP, College Station, TX, USA). Results for continuous or chiselled outcomes were reported as a mean difference or an odds ratio, respectively, with 95% confidence intervals.

Results

Literature search

A total of 2051 studies were selected subsequently an intensive database search on PubMed (n = 976), Embase (n = 1050) and Cochrane (n = 15). Of these 2051 articles, 2045 manufactures were excluded afterward title/abstracts review. Vi manufactures that met our inclusion criteria were subsequently included later on a total-text review. From these manufactures, 1 article was excluded as it reported unlike types of SLAP repair. Finally, five unique studies that met our study criteria were used for this meta-assay (Effigy ane). Three were retrospective cohort studies (LOE Three), i was a case-control study and one was a double-blind, sham-controlled trial (LOE II) and reported from 2009 to 2022 (Table 1).

Flow chart summarising study profile and choice procedure.

Table i

Characteristics of the included studies.

Author	Study, LoE	Participants	Intervention	Follow-up time	Outcomes
Boileau P et al [9]	Accomplice study, III	25 sequent patients operated for an isolated Type II SLAP lesion between 2000 and 2004	10 SLAP repair 15 tenodesis	Minimum two years SLAP repair: 35 (24–69) months Tenodesis: 34 (24–68) months	Constant score, patient satisfaction, sports level and reoperation rate
Denard PJ et al [26]	Retrospective cohort written report, Iii	37 patients surgically managed isolated Type II SLAP lesions between November 2003 and February 2009	22 SLAP repair 15 tenodesis	Minimum 2 years SLAP repair: 63.2 ± fourteen.5 months Tenodesis group: 41.one ± 19.viii months	Patient satisfaction, sports level, UCLA score, ASES score, VAS score and ROM
Ek et al [25]	Retrospective accomplice study, III	25 patients who had undergone surgery for an isolated Type II SLAP lesion betwixt 2008 and 2022	10 SLAP repair 15 tenodesis	Minimum 24 months SLAP repair: mean 35 months (range, 25–52) Tenodesis group: mean 31 months (range, 26–43)	Patient satisfaction, sports level, ASES score, VAS score and SSV score
Zhao et al [19]	Case-control study, 4	38 patients with Type 2 SLAP injury were treated with SLAP repair and biceps tenodesis from March 2009 to March 2022	22 SLAP repair sixteen tenodesis	2 years	UCLA score and SST score
Schrøder et al [27]	Double-blind three-armed randomised, sham-controlled study, I	118 patients with Blazon II SLAP injury were treated with SLAP repair and biceps tenodesis from January 2008 to January 2022	40 labral repair 39 tenodesis 39 sham surgery	two years	WOSI and Rowe score, OISS score, the EuroQol (EQ-5D, EQ-VAS) and patient satisfaction

Demographics

In our study, a full of 204 patients were analysed from the selected 5 studies, which included 104 SLAP repairs and 100 biceps tenodesis. Generally, no meaning difference was observed in the baseline age of the patients between the cohorts (p = 0.157, Fig. two).

Standard differences in means for patient ages between biceps tenodesis and SLAP repair groups.

SLAP = superior labrum anterior and posterior.

Surgical result score

Patients were clinically assessed both preoperatively and postoperatively on a number of outcome-based scores that included the UCLA score, ASES score and VAS score in the studies. The UCLA score was evaluated in 2 of the five studies with statistically significant improvement from preoperatively to postoperatively at the final follow-up. A standard mean difference of −0.155 (−0.615 to 0.306) was determined (p = 0.510), implying that no significant departure was found in the UCLA score among the two cohorts (Fig. 3A). 2 studies among the five selected studies were evaluated for the ASES score. A standard hateful difference of −0.024 (−0.532 to 0.483) was found (p = 0.925). No significant difference was observed between the two cohorts for the ASES score (Fig. 3B). The VAS score was evaluated in two studies. A standard mean difference of −0.198 (−0.311 to 0.708) was found (p = 0.446). No significant difference was observed regarding the VAS score betwixt the two cohorts (Fig. threeC).

Standard differences in means for functional scores (UCLA increased score, ASES score and VAS score) between biceps tenodesis and SLAP repair groups.

ASES = American Shoulder and Elbow Surgeons; SLAP = superior labrum anterior and posterior; UCLA = University of California at Los Angeles; VAS, visual analogue scale.

Patient satisfaction

Four studies evaluated the patients' satisfaction effect. An odds ratio of 0.294 (0.091–0.955) was found in favour of tenodesis (p = 0.042), thereby indicating that the patient satisfaction was significantly better in the biceps tenodesis group than in the SLAP repair group (Fig. 4).

Odds ratios for patient satisfaction between biceps tenodesis and SLAP repair groups.

SLAP = superior labrum inductive and posterior.

Return to sporting activity

Three of five studies selected had evaluated return to sporting activity betwixt the two groups. An odds ratio of 0.170 (0.031–0.950) was measured in favour of the tenodesis group (p = 0.044), thus indicating that the incidence of patients who postoperatively return to reinjury sports activity was significantly improve in the tenodesis group than in the SLAP repair group (Fig. 5).

Odds ratios for patient return to sporting activity between biceps tenodesis and SLAP repair groups.

SLAP = superior labrum inductive and posterior.

Postoperative stiffness

Postoperative stiffness was examined in 3 studies. An odds ratio of 2.127 (0.650–6.957) was measured (p = 0.212). No significant difference was found in the postoperative stiffness outcome amid the two cohorts (Fig. 6).

Odds ratios for postoperative stiffness between biceps tenodesis and SLAP repair groups.

SLAP = superior labrum inductive and posterior.

Reoperation

Reoperation was reported in three studies. An odds ratio of 2.698 (0.312–23.326) was measured (p = 0.097). No significant departure was found in the reoperation rate amongst the ii cohorts (Fig. vii).

Odds ratios for reoperation between biceps tenodesis and SLAP repair groups.

SLAP = superior labrum anterior and posterior.

Discussion

Blazon II SLAP lesions could cause severe pain during shoulder motion, especially overhead, or when lifting objects and significantly reduce ease of shoulder range of motion (ROM) and strength. The current surgical treatments generally comprise one of two, superior labral repair or biceps tenodesis. However, which of the two procedures is preferred treatment of Type 2 SLAP lesion is notwithstanding an active debate in clinical field. In this study, we performed a meta-analysis to determine whether there is discrepancy in the outcomes between the two procedures postoperatively. Based on report pattern criteria, five articles (204 patients) were selected and assessed in this meta-analysis. The results obtained imply that the prevalence of the patient satisfaction and patients who return to preinjury sports level was significantly greater in the tenodesis grouping than in the SLAP repair group (p < 0.05) postoperatively. As for the measures such every bit patient historic period, VAS score, ASES score UCLA score, postoperative stiffness and reoperation rates, no meaning differences was found among the two cohorts, thus befitting to the results reported in the currently bachelor literature (p > 0.05).

Friel et al reported that arthroscopic SLAP repair of Type Ii lesions with bio-absorbable suture anchors could significantly better shoulder functional capacity and pain relief postoperatively [14]. However, other studies have reported poor results with patient satisfaction and return of activity subsequently SLAP repair [fifteen], [16], [17], [eighteen], [19]. In a retrospective case study, Yung et al reported that postoperative UCLA scores in patients who underwent Type II SLAP repair ranged from excellent to moderate scores in 75% of patients, whereas the remaining 25% had poor UCLA scores [twenty]. Likewise, Boileau et al reported a constant improvement in scores from 65 to 83 points in patients after SLAP repair; nonetheless, 60% (half-dozen of x) of the patients reported to be disappointed due to chronic hurting or failure to render to initial sports action participation level [9]. Similarly, Cohen et al as well found that although SLAP repair patients had high outcome scores, patient satisfaction could not be improved past 71%. In addition, effectually 41% of the patients reported experiencing some extent of shoulder pain during the night [21]. These results agreed with our findings that the prevalence of the patient satisfaction and the number of patients who render to preinjury sports activity level were significantly lower in SLAP repair group than in the tenodesis grouping (p < 0.05).

Age is an important factor that is considered an postoperative functional outcome for isolated SLAP repairs. Neri et al get-go evaluated historic period every bit one of the vital factors [22] and reported adept-to-excellent outcomes with higher incidences of return to initial action level for many suitably adamant patients who underwent isolated Blazon II SLAP repair, regardless of the patients' age. On the other hand, numerous reports have indicated that the postoperative outcomes of SLAP repairs are unpredictable, notably in aged patients [23], [24]. Provencher et al evaluated 179 SLAP repair patients [vii] at an average follow-up period of 40.four months and documented that 66 patients reported failure of SLAP repair and 55 patients underwent revision surgery. Advanced historic period (>36 years) was a single measure, among the groups, that was associated with increased failure rate. However, in this study, we could only analyse divergence in ages and reoperation rates in two groups separately, and nosotros found that there were no significant difference in the age and reoperation rate between the ii groups, which may have been due to the small number of studies and patient anticipations, were relatively minor. Further prospective randomised controlled clinical studies with more patient anticipations are needed to analyze information technology.

Moreover, SLAP repair patients are at risk of developing postoperative stiffness, and the patients must also undergo extensive postoperative rehabilitations. Brockmeier et al reported that after SLAP repair surgery, iv patients (8.5%) had observed severe shoulder stiffness. Among them, iii patients achieved near 15^° of the preinjury range of motion past conservative management, whereas the fourth patient had adult severe adhesive capsulitis and attained full motion later on arthroscopic lysis of adhesion [iv]. In our research, we found that iii studies in SLAP repair and one study in tenodesis reported stiffness as the nigh common postoperative complication, which was resolved by bourgeois management such as physical therapy [25] or surgical management including capsular release [26] and tenodesis [27]. However, over long-term follow-up, in that location was no significant departure in incidences of postoperative stiffness between the ii treatments.

In the United States, at that place is a decreasing trend in SLAP repair from 69.three% to 44.8%, whereas an increasing trend of incidences of biceps tenodesis from 1.ix% to eighteen.viii% was observed from 2003 to 2022 [28]. Erickson et al also studied the contempo trends in SLAP repair surgeries between 2004 and 2022. They plant that the total number of biceps tenodesis had significantly increased, whereas the number and relative percentage of SLAP repairs had significantly decreased over the past 10 years [29]. Furthermore, biceps tenodesis can likewise be used as revision treatment of failed SLAP repair. Boileau et al [9] reported that four patients with failed SLAP repairs underwent subsequent biceps tenodesis, with favourable outcomes and a total return to their previous level of sports activity. In view of this, nosotros suggest that biceps tenodesis could be efficiently performed and achieve better outcomes in instance of failed SLAP repair.

Limitations

In this study, in that location are a few limitations. Start, the small number of studies was inducted for meta-analysis, and 3 of the included studies involved the use of a retrospective database. 2nd, comparatively minor sample number of patients was available for analysis. Third, there was a lack of sufficient number of studies that focused on the outcome of biceps tenodesis in younger patients with Type 2 SLAP injury. These limitations could be overcome through a multicenter randomised controlled clinical written report involving both older and younger patients.

Conclusions

Both the procedures, SLAP repair and biceps tenodesis, are effective in pain relief and recovery of functional activity in patients suffering from isolated Type II SLAP lesions. Compared with SLAP repair, biceps tenodesis could attain higher rate of patient satisfaction and greater number of patients could render to preinjury sports participation. In view of this, biceps tenodesis could be a preferable choice to SLAP repair, especially for failed SLAP repair patients.

Conflict of interest

All the authors declare no conflict of interest.

Acknowledgements

This research was supported by the National Natural Science Foundation of Mainland china (No. 81301578).

Footnotes

Appendix A. Supplementary data

The following is the Supplementary data to this commodity:

References

1. Andrews J.R., Carson W.G., Jr., McLeod W.D. Glenoid labrum tears related to the long head of the biceps. Am J Sports Med. 1985;13(five):337–341. [eng] [PubMed] [Google Scholar]

2. Snyder S.J., Karzel R.P., Del Pizzo W., Ferkel R.D., Friedman Thou.J. SLAP lesions of the shoulder. Arthrosc: J Arthrosc Relat Surg: Off Publ Arthrosc Assoc Northward Am Int Arthrosc Assoc. 1990;6(iv):274–279. [eng] [Google Scholar]

3. Snyder Southward.J., Banas M.P., Karzel R.P. An analysis of 140 injuries to the superior glenoid labrum. J Shoulder Elbow Surg. 1995;4(four):243–248. [eng] [PubMed] [Google Scholar]

four. Brockmeier S.F., Voos J.East., Williams R.J., 3rd, Altchek D.W., Cordasco F.A., Allen A.A. Outcomes after arthroscopic repair of type-II SLAP lesions. J Os Jt Sur Am Vol. 2009;91(7):1595–1603. [eng] [PMC free commodity] [PubMed] [Google Scholar]

5. Boesmueller S., Tiefenboeck T.M., Hofbauer Thou., Bukaty A., Oberleitner 1000., Huf W. Progression of part and hurting relief as indicators for returning to sports subsequently arthroscopic isolated type II SLAP repair—a prospective written report. BMC Muscoskel Disord. 2017;xviii(☆) [PMC free commodity] [PubMed] [Google Scholar]

half dozen. Huri Yard., Hyun Y.S., Garbis N.One thousand., McFarland Due east.G. Treatment of superior labrum anterior posterior lesions: a literature review. Acta Orthop Traumatol Turcica. 2014;48(3):290–297. [eng] [PubMed] [Google Scholar]

7. Provencher M.T., McCormick F., Dewing C., McIntire S., Solomon D. A prospective assay of 179 type 2 superior labrum inductive and posterior repairs: outcomes and factors associated with success and failure. Am J Sports Med. 2013;41(iv):880–886. [eng] [PubMed] [Google Scholar]

8. Waterman Thou.B.R., Arroyo C.W., Heida C.K., Burks C.R., Pallis C.M. SLAP repairs with combined procedures take lower failure rate than isolated repairs in a military machine population: surgical outcomes with minimum ii-year follow-upwards. Orthop J Sports Med. 2015;3(viii):861–873. [PMC free article] [PubMed] [Google Scholar]

nine. Boileau P., Parratte S., Chuinard C., Roussanne Y., Shia D., Bicknell R. Arthroscopic treatment of isolated type Two SLAP lesions: biceps tenodesis as an alternative to reinsertion. Am J Sports Med. 2009;37(five):929–936. [PubMed] [Google Scholar]

10. Alpert J.G., Wuerz T.H., O'Donnell T.F., Carroll Chiliad.M., Brucker N.N., Gill T.J. The consequence of age on the outcomes of arthroscopic repair of type Two superior labral inductive and posterior lesions. Am J Sports Med. 2010;38(xi):2299–2303. [eng] [PubMed] [Google Scholar]

eleven. Denard P.J., Ladermann A., Burkhart Due south.Southward. Long-term outcome later arthroscopic repair of type II SLAP lesions: results according to historic period and workers' compensation condition. Arthrosc: J Arthrosc Relat Surg: Off Publ Arthrosc Assoc N Am Int Arthrosc Assoc. 2012;28(4):451–457. [eng] [PubMed] [Google Scholar]

12. Kanatli U., Ozturk B.Y., Bolukbasi S. Arthroscopic repair of type II superior labrum anterior posterior (SLAP) lesions in patients over the historic period of 45 years: a prospective report. Arch Orthop Trauma Surg. 2011;131(8):1107–1113. [eng] [PubMed] [Google Scholar]

13. Schroder C.P., Skare O., Gjengedal E., Uppheim G., Reikeras O., Brox J.I. Long-term results after SLAP repair: a five-year follow-up study of 107 patients with comparing of patients aged over and nether forty years. Arthrosc: J Arthrosc Relat Surg: Off Publ Arthrosc Assoc N Am Int Arthrosc Assoc. 2012;28(11):1601–1607. [eng] [PubMed] [Google Scholar]

14. Friel N.A., Karas V., Slabaugh M.A., Cole B.J. Outcomes of type Ii superior labrum, anterior to posterior (SLAP) repair: prospective evaluation at a minimum two-twelvemonth follow-upward. J Shoulder Elbow Surg. 2010;xix(6):859–867. [PMC gratis article] [PubMed] [Google Scholar]

15. Kim S.H., Ha K.I., Choi H.J. Results of arthroscopic treatment of superior labral lesions. J Bone Jt Surg Am Vol. 2002;84-A(vi):981. [PubMed] [Google Scholar]

sixteen. Ide J., Maeda Due south., Takagi K. Sports activity after arthroscopic superior labral repair using suture anchors in overhead-throwing athletes. Am J Sports Med. 2005;33(4):507–514. [PubMed] [Google Scholar]

17. Gorantla K., Gill C., Wright R.Due west. The consequence of type II SLAP repair: a systematic review. Arthrosc J Arthrosc Relat Surg. 2010;26(four):537–545. [PubMed] [Google Scholar]

18. Katz L.One thousand., Hsu Due south., Miller South.Fifty., Richmond J.C., Khetia E., Kohli N. Poor outcomes after SLAP repair: descriptive assay and prognosis. Arthrosc: J Arthrosc Relat Surg: Off Publ Arthrosc Assoc N Am Int Arthrosc Assoc. 2009;25(8):849–855. [eng] [PubMed] [Google Scholar]

19. Zhao C., Hu J.T., Kong G.Ten., Qiu B.S., Gu H.F., Zhang S.J. Case-control study on superior labrum from anterior to posterior repair and biceps tenodesis for the treatment of blazon II SLAP injury. Zhongguo Gu Shang. 2015;28(six):531–535. [PubMed] [Google Scholar]

twenty. Yung P.S., Fong D.T., Kong M.F., Lo C.M., Fung K.Y., Ho East.P. Arthroscopic repair of isolated type II superior labrum anterior-posterior lesion. Articulatio genus Surg Sports Traumatol Arthrosc: Off J ESSKA. 2008;sixteen(12):1151–1157. [eng] [PubMed] [Google Scholar]

21. Cohen D.B., Coleman S., Drakos M.C., Allen A.A., O'Brien Due south.J., Altchek D.W. Outcomes of isolated type II SLAP lesions treated with arthroscopic fixation using a bioabsorbable tack. Arthrosc J Arthrosc Relat Surg. 2006;22(2):136–142. [PubMed] [Google Scholar]

22. Neri B.R., Vollmer Eastward.A., Kvitne R.S. Isolated type II superior labral anterior posterior lesions: age-related effect of arthroscopic fixation. Am J Sports Med. 2009;37(5):937–942. [eng] [PubMed] [Google Scholar]

23. Erickson J., Lavery K., Monica J., Gatt C., Dhawan A. Surgical treatment of symptomatic superior labrum inductive-posterior tears in patients older than 40 years: a systematic review. Am J Sports Med. 2015;43(five):1274–1282. [PubMed] [Google Scholar]

24. Weber South.C., Martin D.F., Rd Due south.J., Harrast J.J. Superior labrum anterior and posterior lesions of the shoulder: incidence rates, complications, and outcomes as reported past American Board of Orthopedic Surgery. Function Two candidates. Am J Sports Med. 2012;40(7):1538–1543. [PubMed] [Google Scholar]

25. Ek Eastward.T., Shi L.Fifty., Tompson J.D., Freehill M.T., Warner J.J. Surgical handling of isolated type 2 superior labrum anterior-posterior (SLAP) lesions: repair versus biceps tenodesis. J Shoulder Elbow Surg. 2014;23(7):1059–1065. [PubMed] [Google Scholar]

26. Denard P.J., Parsley B.Chiliad., Burkhart S.South. Arthroscopic biceps tenodesis compared with repair of isolated type Ii SLAP lesions in patients older than 35 years. Orthopedics. 2014;37(3):e292–e297. [PubMed] [Google Scholar]

27. Schrøder C.P., Skare Ø., Reikerås O., Mowinckel P., Brox J.I. Sham surgery versus labral repair or biceps tenodesis for blazon 2 SLAP lesions of the shoulder: a iii-armed randomised clinical trial. Br J Sports Med. 2017;51(24):1759–1766. [PMC free article] [PubMed] [Google Scholar]

28. Mackinnonpatterson B., Creighton R.A., Spang J.T., Kamath G.V. Surgical trends in the treatment of superior labrum anterior and posterior (SLAP) lesions of the shoulder. Assay of information from the American Board of Orthopaedic Surgery Certification Test Database. Am J Sports Med. 2014;two(two Suppl):1904–1910. [Google Scholar]

29. Erickson B.J., Jain A., Abrams Grand.D., Nicholson G.P., Cole B.J., Romeo A.A. SLAP lesions: trends in handling. Arthrosc: J Arthrosc Relat Surg: Off Publ Arthrosc Assoc N Am Int Arthrosc Assoc. 2016;32(6):976–981. [eng] [Google Scholar]

Articles from Journal of Orthopaedic Translation are provided here courtesy of Chinese Speaking Orthopaedic Social club