title: Is there an association between SLAP lesions and biceps pulley lesions?
abstract: OBJECTIVE
  The purpose of this study was to evaluate the prevalence of SLAP and biceps reflection pulley lesions. The hypothesis was that these lesions do not occur concomitantly and they have a different etiology.
  
  
  METHODS
  We prospectively analyzed 3,395 shoulder arthroscopies that were independently performed by 2 surgeons between 2004 and 2008 regarding the prevalence of SLAP and biceps pulley lesions. Intraoperative findings were correlated with patient history and clinical examination. Exclusion criteria were type I SLAP lesions, full-thickness rotator cuff tears, and a history of shoulder dislocation.
  
  
  RESULTS
  This study included 182 patients with SLAP lesions (prevalence, 5.4%; 138 men; mean age, 47 years) and 87 patients with pulley lesions (prevalence, 2.6%; 63 men; mean age, 49 years). Isolated SLAP lesions were present in 157 cases, and isolated pulley lesions in 62 cases. The concomitant presence of a SLAP lesion and pulley lesion was significantly rare (10%, P = .003). In 55 (35%; 42 men [76%]; mean age, 43 years) of the cases with isolated SLAP lesions and 40 (65%; 27 men [68%]; mean age, 49 years) with isolated pulley lesions, there was a significant association with history of trauma (P < .01). Most SLAP lesions (32 [58%], P = .174 [not significant]) and most pulley lesions (28 [70%], P < .01) resulted from falling on the outstretched arm with external arm rotation in SLAP lesions and internal rotation in pulley lesions (P > .05).
  
  
  CONCLUSIONS
  The concomitant presence of biceps tendon-associated lesions in the form of SLAP and pulley lesions is significantly rare. A history of falling on the abducted and externally rotated arm was typical in patients with SLAP lesions, whereas a fall on the arm with internal rotation was often noted in patients with pulley lesions.
  
  
  METHODS
  Level IV, therapeutic case series.
authors.affiliation: Department of Shoulder and Elbow Surgery, ATOS Clinic, Heidelberg, Germany.
authors.forename: Thilo
authors.initials: T
authors.lastname: Patzer
authors.forename: Jörn
authors.initials: J
authors.lastname: Kircher
authors.forename: Sven
authors.initials: S
authors.lastname: Lichtenberg
authors.forename: Matthias
authors.initials: M
authors.lastname: Sauter
authors.forename: Petra
authors.initials: P
authors.lastname: Magosch
authors.forename: Peter
authors.initials: P
authors.lastname: Habermeyer
mesh_terms: D000058:Accidental Falls; D000293:Adolescent; D000328:Adult; D000368:Aged; D001182:Arthroscopy; D001265:Athletic Injuries / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery; D002358:Cartilage, Articular / Q000293:injuries* / Q000601:surgery; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery; D008022:Ligaments / Q000293:injuries* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000453:epidemiology* / Q000601:surgery; D015995:Prevalence; D011446:Prospective Studies; D017006:Rotator Cuff / Q000601:surgery; D000070636:Rotator Cuff Injuries; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000601:surgery; D013708:Tendon Injuries / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery; D013710:Tendons / Q000503:physiopathology / Q000601:surgery; D053656:Tenodesis; D055815:Young Adult