The clavicle (collarbone), scapula (Shoulder blade), and the humerus (upper arm bone) are the three major bones found in your shoulder joint. Within the shoulder joint, there also exists the glenoid located in the shallow socket of the shoulder blade. This is particularly, where the head of the upper arm bone rests.
The humeral head is actually larger than the glenoid socket. This socket is surrounded by a fibrous tissue known as “labrum”. The labrum provides additional stability, deepens the socket, and also serves as an attachment to the vital ligaments. The biceps tendon is connected to the labrum at the top, which is known as the “SLAP region”.
A SLAP Tear or Lesion!
SLAP tears or lesions “Superior Labrum Anterior and Posterior” are common orthopaedic injuries. The SLAP Tear or lesion develops in the superior the anterior and posterior of the point where the biceps tendon connects to the Labrum.
Possible Causes of SLAP Lesions
Some of the possible causes of SLAP Lesions include;
- Chronic degenerative
- Shoulder dislocations
- Sudden falling or accidents that affect the shoulder
- Sports activities
SLAP Tear or Lesion Repair & Treatment
A repair is generally an excellent approach to treating SLAP Tear or Lesions. There are various techniques for repair and in the real sense; there is a high incidence of the concomitant pathology of the shoulder.
In the modern era, Arthroscopic SLAP tear repair is more desirable in case non-surgical treatments fail to eliminate pain. In addition, SLAP repairs, Debridement, arthroscopic biceps tenodesis or tenotomy are also possible repair approaches. These are generally performed to correct dislocations.
Repair is common for patients with trauma triggered tears or those triggered by overhead sports. This is associated to SLAP tears that involve the top portion of the labrum, basically where the biceps tendon attaches.
In other patients, SLAP tears or lesions are treated by freeing the biceps tendon from the torn labrum. The surgeon will then join them to lower down on the humerus bone. Repair is an individualized treatment that eliminates pain and improves function in the long run.
When using the arthroscopic approach, rather than the open surgery, the procedure is generally minimally invasive since tiny instruments are utilized to correct the dislocation.
Forms of Tears
SLAP tears can be categorized as below;
- Type 1- Fraying of the superior labrum and biceps; with this, patients may be asymptomatic
- Type 2- It is the commonest form of tear and in it, both superior labrum and biceps anchor are disconnected from the glenoid
- Type 3- Bucket-handle tear of superior labrum; biceps anchor intact, however
- Type 4- Bucket-handle tear of superior labrum that extends into fibers of biceps, commonly creating split appearance of tendon
- Type 5- This is the Anteroinferior Bankart lesion that continues superiorly to include separation of the biceps tendon
- Type 6- Characterized by unstable flap tear of the labrum with biceps tendon separation
- Type 7- This is a SLAP lesion that extends anteroinferiorly along labrum to below MGHL
- Pain associated with overhead activities
- Pain while lifting heavy objects
- Loss of velocity
- A feeling of locking, grinding, or popping in the shoulder
- A “dead arm” feeling
Most tears are generally treated with nonoperative management approaches that include medicines “nonsteroidal anti-inflammatories” and physical therapy.