Arthroscopic treatment of isolated type II SLAP lesions: biceps tenodesis as an alternative to reinsertion.
BACKGROUND
Overhead athletes report an inconsistent return to their previous level of sport and satisfaction after arthroscopic SLAP lesion repair.


OBJECTIVE
Arthroscopic biceps tenodesis offers a viable alternative to the repair of an isolated type II SLAP lesion.


METHODS
Cohort study; Level of evidence, 3.


METHODS
Twenty-five consecutive patients operated for an isolated type II SLAP lesion between 2000 and 2004 were evaluated at a mean of 35 months postoperatively (range, 24-69). Patients with associated instability, rotator cuff rupture, posterosuperior impingement, or previous shoulder surgery were excluded. Ten patients (10 men) with an average age of 37 years (range, 19-57) had a SLAP repair performed with suture anchors. Fifteen patients (9 men and 6 women) with an average age of 52 years (range, 28-64) underwent arthroscopic biceps tenodesis performed with an absorbable interference screw. Arthroscopic diagnosis and treatment were performed by a single experienced shoulder surgeon, and all patients were reviewed by an independent examiner.


RESULTS
In the repair group, the Constant score improved from 65 to 83 points; however, 60% (6 of 10) of the patients were disappointed because of persistent pain or inability to return to their previous level of sports participation. In the tenodesis group, the Constant score improved from 59 to 89 points, and 93% (14/15) were satisfied or very satisfied. Thirteen patients (87%) were able to return to their previous level of sports participation following biceps tenodesis, compared with only 20% (2 of 10) after SLAP repair (P = .01). Four patients with failed SLAP repairs underwent subsequent biceps tenodesis, resulting in a successful outcome and a full return to their previous level of sports activity.


CONCLUSIONS
Arthroscopic biceps tenodesis can be considered an effective alternative to the repair of a type II SLAP lesion, allowing patients to return to a presurgical level of activity and sports participation. The results of biceps reinsertion are disappointing compared with biceps tenodesis. Furthermore, biceps tenodesis may provide a viable alternative for the salvage of a failed SLAP repair. As the age of the 2 treatment groups differed, these findings should be confirmed by future studies.
Boileau
Pascal
P
Department of Orthopaedics and Sports Traumatology, Hôpital de l'Archet 2, 151 Route de St Antoine de Ginestière, 06200 Nice, France. boileau.p@chu-nice.fr
Parratte
Sebastien
S
Chuinard
Christopher
C
Roussanne
Yannick
Y
Shia
Derek
D
Bicknell
Ryan
R
D020341:Absorbable Implants; D000328:Adult; D001182:Arthroscopy; D001863:Bone Screws; D004551:Elbow Joint / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D053581:Muscle Strength Dynamometer; D010147:Pain Measurement; D017060:Patient Satisfaction; D011446:Prospective Studies; D016059:Range of Motion, Articular; D024162:Second-Look Surgery; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000503:physiopathology / Q000601:surgery; D053441:Suture Anchors; D013708:Tendon Injuries / Q000601:surgery*; D053656:Tenodesis / Q000295:instrumentation / Q000379:methods*