title: Surgical treatment of isolated type II superior labrum anterior-posterior (SLAP) lesions: repair versus biceps tenodesis.
abstract: BACKGROUND
  It is still unclear which patients with isolated type II superior labrum anterior-posterior (SLAP) lesions benefit from either superior labral repair or biceps tenodesis. This study evaluates the indications and outcomes of patients with isolated type II SLAP lesions who have undergone either procedure.
  
  
  METHODS
  A retrospective analysis was performed of patients who had surgery for an isolated type II SLAP lesion between 2008 and 2011. There were 25 patients: 15 underwent biceps tenodesis, with a mean follow-up of 31 months (range, 26-43 months), and 10 underwent SLAP repair, with a mean follow-up of 35 months (range, 25-52 months). The mean age was 47 years (range, 30-59 years) in the tenodesis group and 31 years (range, 21-43 years) in the repair group.
  
  
  RESULTS
  At latest follow-up, both groups showed significant improvements in subjective shoulder value and pain score. No difference was observed in American Shoulder and Elbow Surgeons score (93.0 vs 93.5, P = .45), patient satisfaction (93% vs 90%, P = .45), or return to preinjury sporting level (73% vs 60%, P = .66). Analysis of the indications for treatment showed that in the large majority, tenodesis was performed in older patients (>35 years) and patients who showed degenerative or frayed labrums whereas SLAP repairs were performed in younger and more active patients with healthy-appearing labral tissue. There was only 1 failure in the tenodesis group, and in the SLAP repair group, there were 2 cases of postoperative stiffness; all were treated nonoperatively.
  
  
  CONCLUSIONS
  In this study, we show that both biceps tenodesis and SLAP repair can provide good to excellent results if performed in appropriately selected patients with isolated type II SLAP lesions.
authors.affiliation: Melbourne Orthopaedic Group and Department of Orthopaedic Surgery, University of Melbourne, Austin Hospital, Melbourne, Australia.
authors.forename: Eugene T H
authors.initials: ET
authors.lastname: Ek
authors.affiliation: Department of Orthopaedic Surgery and Rehabilitation Medicine, The University of Chicago Hospitals, Chicago, IL, USA.
authors.forename: Lewis L
authors.initials: LL
authors.lastname: Shi
authors.affiliation: Harvard Shoulder Service, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Tompson
authors.affiliation: Sports and Shoulder Service, Department of Orthopaedic Surgery, Wake Forest University Baptist Medical Center, Winston-Salem, NC, USA.
authors.forename: Michael T
authors.initials: MT
authors.lastname: Freehill
authors.affiliation: Harvard Shoulder Service, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. Electronic address: jwarner@partners.org.
authors.forename: Jon J P
authors.initials: JJ
authors.lastname: Warner
mesh_terms: D000328:Adult; D001182:Arthroscopy; D015331:Cohort Studies; D005260:Female; D051445:Fibrocartilage / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012540:Scapula / Q000293:injuries / Q000601:surgery*; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000601:surgery*; D017695:Soft Tissue Injuries / Q000601:surgery*; D013708:Tendon Injuries / Q000601:surgery*; D053656:Tenodesis
keywords: SLAP lesion; biceps tenodesis; labrum; superior labral repair