SLAP lesion
SLAP stands for Superior labrum anterior to posterior. The labrum is a rim of connective tissue which deepens the socket of the glenoid. The tendon of the long head of the biceps is attached to it.
Causes and risk factors
A fall on the outstretched hand held close to the body poses the greatest risk for a labral tear. Athletes and sportsmen who are involved in overhead activities are also at risk of developing a SLAP lesion. Motor vehicular accidents can also cause the lesion. Dislocation and a rotator cuff tear are precipitating causes of a tear. asd
Diagnosis
The diagnosis is not easy. It requires a MRI scan or a diagnostic arthroscopy to pick up the tear.
Treatment
Conservative treatment consists of anti- inflammatory medication. A diagnostic arthroscopy is first done. The labral tear at the upper part (superior) is first identified by probing with the hook. The extent of the tear is determined. There may be only fraying of the biceps tendon in the milder variety. In advanced cases the superior labrum is detached from its attachment anterior to posterior and the biceps tendon may thus have lost its attachment.
The frayed end of the tendon can be debrided arthroscopically.Where there is a big tear this can be repaired arthroscopically using special suture anchors. An open method uses a small incision at the top of the shoulder.
If there is associated instability or a rotator cuff tear then these may need correction. |
