Repair of SLAP lesions associated with a Buford complex: a novel surgical technique.
OBJECTIVE
The purpose of this study was to analyze outcomes of a novel arthroscopic repair technique for type II SLAP lesions associated with a Buford complex.


METHODS
Patients selected for study enrollment had a symptomatic, isolated type II SLAP lesion and the Buford complex anatomic variant. Excluded were patients undergoing any concomitant shoulder procedure (e.g., subacromial decompression) or with any history of shoulder surgery. In addition to standard type II SLAP repair using suture anchors, the described technique also transects the cordlike middle glenohumeral ligament (MGHL) at the equator of the glenoid. This decreases postoperative stress on the repair and allows incorporation of the proximal MGHL segment for repair augmentation. The stout proximal MGHL segment is fixed to the anterosuperior glenoid rim, which is devoid of labral tissue, to enhance fixation of the SLAP repair anterior to the biceps anchor. The distal MGHL segment is left free so as to not impair external rotation. A single surgeon performed all procedures using the same surgical technique. Outcomes were assessed by University of California, Los Angeles (UCLA) and Constant shoulder scoring indexes.


RESULTS
Twenty-one patients were evaluated. Both UCLA and Constant shoulder scores showed a statistically significant improvement after surgery. The mean UCLA score increased from 14.3 preoperatively to 32.1 postoperatively (P < .0001). The mean Constant score improved from 39.7 to 85.0 (P < .0001). Follow-up examination was performed at a mean of 44 months after surgery (range, 23 to 75 months). No patients had evidence of postoperative instability.


CONCLUSIONS
For patients with a symptomatic type II SLAP tear and an associated Buford complex, using the proximal Buford MGHL to enhance repair and releasing the distal Buford MGHL segment resulted in significant improvement in outcomes at intermediate follow-up.


METHODS
Level IV, therapeutic case series.
Trails West Sports Medicine, Kearney, Nebraska, USA.
Heber C
HC
Crockett
Nathaniel C
NC
Wingert
John M
JM
Wright
Kevin F
KF
Bonner
D000328:Adult; D001182:Arthroscopy / Q000379:methods*; D001265:Athletic Injuries / Q000601:surgery; D005260:Female; D006801:Humans; D008023:Ligaments, Articular / Q000002:abnormalities* / Q000293:injuries / Q000601:surgery*; D008297:Male; D012189:Retrospective Studies; D012785:Shoulder Joint / Q000601:surgery*; D053441:Suture Anchors; D013536:Suture Techniques; D016896:Treatment Outcome