No advantages in repairing a type II superior labrum anterior and posterior (SLAP) lesion when associated with rotator cuff repair in patients over age 50: a randomized controlled trial.
BACKGROUND
Arthroscopic management has been recommended for some superior labrum anterior and posterior (SLAP) lesions, but no studies have focused on patients over 50 years of age with rotator cuff tear and a type II SLAP lesion.


OBJECTIVE
In patients over 50 years of age with an arthroscopically confirmed lesion of the rotator cuff and a type II SLAP lesion, there is no difference between (1) repair of both lesions and (2) repair of the rotator cuff tear without repair of the SLAP II lesion but with a tenotomy of the long head of the biceps.


METHODS
Randomized controlled clinical trial; Level of evidence, 1.


METHODS
We recruited 63 patients. In 31 patients, we repaired the rotator cuff and the type II SLAP lesion (group 1). In the other 32 patients, we repaired the rotator cuff and tenotomized the long head of the biceps (group 2). Seven patients (2 in group 1 and 5 in group 2) were lost to final follow-up.


RESULTS
At a minimum 2.9 years' follow-up, statistically significant differences were seen with respect to the University of California, Los Angeles (UCLA) score and range of motion values. In group 1 (SLAP repair and rotator cuff repair), the UCLA showed a statistically significant improvement from a preoperative average rating of 10.4 (range, 6-14) to an average of 27.9 (range, 24-35) postoperatively (P < .001). In group 2 (biceps tenotomy and rotator cuff repair), the UCLA showed a statistically significant improvement from a preoperative average rating of 10.1 (range, 5-14) to an average of 32.1 (range, 30-35) postoperatively (P <.001) There was a statistically significant difference in total postoperative UCLA scores and range of motion when comparing the 2 groups postoperatively (P < .05).


CONCLUSIONS
There are no advantages in repairing a type II SLAP lesion when associated with a rotator cuff tear in patients over 50 years of age. The association of rotator cuff repair and biceps tenotomy provides better clinical outcome compared with repair of the type II SLAP lesion and the rotator cuff.
Franceschi
Francesco
F
Department of Orthopaedic and Trauma Surgery, Campus Biomedico University, Rome, Italy.
Longo
Umile Giuseppe
UG
Ruzzini
Laura
L
Rizzello
Giacomo
G
Maffulli
Nicola
N
Denaro
Vincenzo
V
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001182:Arthroscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D016059:Range of Motion, Articular / Q000502:physiology; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000503:physiopathology / Q000601:surgery*; D053441:Suture Anchors; D013708:Tendon Injuries / Q000145:classification / Q000601:surgery*; D016896:Treatment Outcome