title: [Is the patient age a negative predictive factor in the reconstruction of SLAP lesions?].
abstract: BACKGROUND
  The treatment strategy of SLAP (superior labrum anterior posterior) lesions is generally a matter of controversy, particularly in patients over 40 years of age. Various factors, such as the increasing number of associated injuries in older age, play a role in the decision-making process. There currently is no empirical evidence for the greater efficacy of treatment planning for SLAP repair as compared to tenodesis/tenotomy. The aim of this study was to analyse, as part of a cohort comparison, the results after SLAP repair in patients under and over 40 years of age.
  
  
  METHODS
  We followed 45 patients after surgical treatment of a SLAP lesion, with a mean follow-up of 60 months (5 years), clinically using the Constant score (CS), the Rowe score, and the "subjective shoulder value" (SSV). Of these, 18 patients in group 1 (age at surgery<40 years, mean age at surgery 29 years, range: 21-39 years) and 27 patients in group 2 (age≥40 years at surgery, mean age at surgery 50 years, range: 40-60 years).
  
  
  RESULTS
  A mean CS of 89% (min 16%-max 105%) resulted. The Rowe score averaged 90 points (min. 35 points-max 100 points), while the SSV averaged 90% (min 20%-max 100%). In comparing the two groups, neither displayed a significant difference in the CS (p=0.198) (group 1: min 58%-max 105%, median 92%, group 2: min 16%-max 105%, median 89%) nor in the Rowe score (p=0.5) (group 1: min 55-max 100 points, median 85 points, group 2: min 35-max 100 points, median 92.5 points). The SSV also showed no significant difference in level (p=0.068) between the two groups (group 1: min 60%-max 100%, median 95%, group 2: min 20%-max 100%, median 90%), although the SSV in group 1 had a better correlation with the CS than in group 2.
  
  
  CONCLUSIONS
  The patient's age seems to have less influence on the outcome after reconstruction of SLAP than previously thought. Even at age≥40 years results show that the reconstruction results of the complex SLAP are comparable with the known literature data, and that it is good clinical practice. Impact on the long-term outcome seems to be particularly dependent on the number and severity of associated injuries, not the patient's age.
authors.affiliation: Orthopädisch-Unfallchirurgisches Zentrum, Medizinische Fakultät Mannheim der Universität Heidelberg, Universitätsmedizin Mannheim. lars.lehmann@umm.de
authors.forename: L J
authors.initials: LJ
authors.lastname: Lehmann
authors.forename: M
authors.initials: M
authors.lastname: Moursy
authors.forename: C
authors.initials: C
authors.lastname: Lederer
mesh_terms: D000328:Adult; D017677:Age Distribution; D002358:Cartilage, Articular / Q000293:injuries* / Q000601:surgery*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D015995:Prevalence; D019651:Plastic Surgery Procedures / Q000706:statistics & numerical data*; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult