title: Greater strength increase with cyst decompression and SLAP repair than SLAP repair alone.
abstract: BACKGROUND
  Treatment of symptomatic spinoglenoid cysts has been controversial with options ranging from observation, to open excision, to arthroscopic decompression with or without labral repair. It has recently been suggested that isolated repair of SLAP lesions without cyst decompression can restore function in patients with spinoglenoid cysts and SLAP lesions.
  
  
  OBJECTIVE
  We examined gains in external rotation strength after isolated SLAP repair versus SLAP repair and cyst decompression to ascertain if gains in external rotation strength are attributable to SLAP repair or cyst decompression.
  
  
  METHODS
  We retrospectively reviewed external rotation strength of 12 patients: six with spinoglenoid cysts and Type II SLAP lesions who underwent arthroscopic SLAP repair and spinoglenoid cyst decompression and six with isolated SLAP lesions who underwent repair of the lesions. Preoperative and postoperative external rotation strength was evaluated using a digitally calibrated dynamometer on the operative and nonoperative sides. The minimum followup was 12 months (mean, 15.2 months; range, 12-27 months).
  
  
  RESULTS
  All of the patients in both cohorts had preoperative external rotation weakness on physical examination and dynamometer testing. The average increase in external rotation strength in the group of patients with SLAP lesions and paralabral cysts was 40% of the contralateral side versus 10% for the cohort with isolated SLAP repairs.
  
  
  CONCLUSIONS
  Decompression of paralabral cysts and SLAP repair in patients with preoperative external rotation weakness resulted in greater strength improvement than in patients with isolated SLAP repairs without complications of suprascapular neuropathy. This suggests that gains in external rotation strength are likely mostly attributable to cyst decompression, questioning isolated SLAP repair in the treatment of patients who have primarily weakness with spinoglenoid cysts.
  
  
  METHODS
  Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
authors.affiliation: Department of Orthopaedic Surgery, Leni & Peter May Department of Orthopaedic Surgery, Mount Sinai School of Medicine, 5 East 98th Street, Box 1188, New York, NY, 10029, USA.
authors.forename: Gita
authors.initials: G
authors.lastname: Pillai
authors.forename: Jason R
authors.initials: JR
authors.lastname: Baynes
authors.forename: James
authors.initials: J
authors.lastname: Gladstone
authors.forename: Evan L
authors.initials: EL
authors.lastname: Flatow
mesh_terms: D000328:Adult; D001182:Arthroscopy / Q000009:adverse effects; D019299:Decompression, Surgical / Q000009:adverse effects; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D053581:Muscle Strength Dynamometer; D009408:Nerve Compression Syndromes / Q000209:etiology / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D009519:New York City; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012189:Retrospective Studies; D012785:Shoulder Joint / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D013581:Synovial Cyst / Q000150:complications / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome