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Abstract

Purpose: To evaluate the results of arthroscopic repair of type II superior labral anterior posterior lesions of the shoulder in overhead athletes.

Hypothesis: Such repair is useful for overhead athletes in terms of postoperative sports activity.

Study Design: Case series; Level of evidence, 4.

Methods: The study group was composed of 40 patients with a mean age of 24 years (range, 15-38 years); mean follow-up was 41 months (range, 24-58 months). They were divided into an overuse (n = 22) and a trauma group (n = 18). The authors used 2 suture anchors loaded with a nonabsorbable suture at the 11-o’clock and 1-o’clock positions through the anterosuperior and lateral trans-rotator cuff portal. A modified Rowe score and postoperative athletic activities were evaluated.

Results: After arthroscopic repair, mean modified Rowe scores improved from 27.5 to 92.1 points (P < .0001). Rated on this scale, the results were excellent in 30 (75%), good in 6 (15%), and fair in 4 (10%) athletes; there were no poor results. Satisfactory outcomes were achieved in 36 (90%) of these patients; 30 (75%) experienced a return to the preinjury level. The complete return rate of baseball players in the overuse group was lower than that of other overhead athletes in the trauma group.

Conclusion: Arthroscopic superior labral repair is a safe and reliable procedure in overhead athletes.

Keywords

superior labral lesion type II superior labral anterior posterior (SLAP) lesion arthroscopic repair suture anchor overhead athletes

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References

Andrews JR

Carson WG Jr

McLeod WD

. Glenoid labrum tears related to the long head of the biceps. Am J Sports Med. 1985;13:337-341.

Bey MJ

Elders GJ

Huston LJ

Kuhn JE

Blasier RB

Soslowsky LJ

. The mechanism of creation of superior labrum, anterior, and posterior lesions in a dynamic biomechanical model of the shoulder: the role of inferior subluxation. J Shoulder Elbow Surg. 1998;7:397-401.

Burkhart SS

Morgan CD

. The peel-back mechanism: its role in producing and extending posterior type II SLAP lesions and its effect on SLAP repair rehabilitation. Arthroscopy. 1998;14:637-640.

Cordasco FA

Steinmann S

Flatow EL

Bigliani LU

. Arthroscopic treatment of glenoid labral tears. Am J Sports Med. 1993;21:425-430.

Crenshaw AH

Kilgore WE

. Surgical treatment of bicipital tenosynovitis. J Bone Joint Surg Am. 1966;48:1496-1502.

Ellman H.

Diagnosis and treatment of incomplete rotator cuff tears. Clin Orthop. 1990;254:64-74.

Field LD

Savoie FH III

. Arthroscopic suture repair of superior labral detachment lesions of the shoulder. Am J Sports Med. 1993;21:783-790.

Grauer JD

Paulos LE

Smutz WP

. Biceps tendon and superior labral injuries. Arthroscopy. 1992;8:488-497.

Hawkins RJ

Misamore GW

. Overview of glenohumeral instability. In: Shoulder Injuries in the Athlete. New York, NY: Churchill Livingstone; 1996:129-137.

10.

Howell SM

Galinat BJ

. The glenoid-labral socket: a constrained articular surface. Clin Orthop. 1989;243:122-125.

11.

Huber WP

Putz RV

. The periarticular fiber system (PAFS) of the shoulder joint. Arthroscopy. 1997;13:680-691.

12.

Ide J

Maeda S

Takagi K

. Arthroscopic Bankart repair using suture anchors in athletes: patient selection and postoperative sports activity. Am J Sports Med. 2004;32:1899-1905.

13.

Ide J

Maeda S

Takagi K

. Normal variations of the glenohumeral ligament complex: an anatomical study for arthroscopic Bankart repair. Arthroscopy. 2004;20:164-168.

14.

Ide J

Maeda S

Yamaga M

Morisawa K

Takagi K

. Shoulder strengthening exercise with an orthosis for multidirectional shoulder instability: quantitative evaluation of rotational shoulder strength before and after the exercise program. J Shoulder Elbow Surg. 2003;12:342-345.

15.

Itoi E

Kuechle DK

Newman SR

Morrey BF

An KN

. Stabilising function of the biceps in stable and unstable shoulders. J Bone Joint Surg Br. 1993;75:546-550.

16.

Kim SH

Ha KI

Kim SH

Choi HJ

. Results of arthroscopic treatment of superior labral lesions. J Bone Joint Surg Am. 2002;84:981-985.

17.

Kumar VP

Satku K

Balasubramaniam P

. The role of the long head of biceps brachii in the stabilization of the head of the humerus. Clin Orthop. 1989;244:172-175.

18.

Maeda S

Ide J

Takagi K

. The efficiency of MR arthrography for labral tears of the shoulder joints in athletes [in Japanese]. Shoulder Joint. 2002;26:407-409.

19.

Maffet MW

Gartsman GM

Moseley B

. Superior labrum-biceps tendon complex lesions of the shoulder. Am J Sports Med. 1995;23:93-98.

20.

Morgan CD

Burkhart SS

Palmeri M

Gillespie M

. Type II SLAP lesions: three subtypes and their relationships to superior instability and rotator cuff tears. Arthroscopy. 1998;14:553-565.

21.

O’Brien SJ

Allen AA

Coleman SH

Drakos MC

. The trans-rotator cuff approach to SLAP lesions: technical aspects for repair and a clinical follow-up of 31 patients at a minimum of 2 years. Arthroscopy. 2002;18:372-377.

22.

O’Brien SJ

Pagnani MJ

Fealy S

McGlynn SR

Wilson JB

. The active compression: a new and effective test for diagnosing labral tears and acromioclavicular joint abnormality. Am J Sports Med. 1998;26:610-613.

23.

Pagnani MJ

Deng XH

Warren RF

Torzilli PA

Altchek DW

. Effect of lesions of the superior portion of the glenoid labrum on glenohumeral translation. J Bone Joint Surg Am. 1995;77:1003-1010.

24.

Pagnani MJ

Speer KP

Altchek DW

Warren RF

Dines DM

. Arthroscopic fixation of superior labral lesions using a biodegradable implant: a preliminary report. Arthroscopy. 1995;11:194-198.

25.

Rodosky MW

Harner CD

Fu FH

. The role of the long head of the biceps muscle and superior glenoid labrum in anterior stability of the shoulder. Am J Sports Med. 1994;22:121-130.

26.

Rowe CR

Patel D

. The Bankart procedure: a long-term end-result study. J Bone Joint Surg Am. 1978;60:1-16.

27.

Samani JE

Marston SB

Buss DD

. Arthroscopic stabilization of type II SLAP lesions using an absorbable tack. Arthroscopy. 2001;17:19-24.

28.

Snyder SJ

Banas MP

Karzel RP

. An analysis of 140 injuries to the superior glenoid labrum. J Shoulder Elbow Surg. 1995;4:243-248.

29.

Snyder SJ

Karzel RP

Del Pizzo W

. SLAP lesion of the shoulder. Arthroscopy. 1990;6:274-279.

30.

Vangsness CT Jr

Jorgenson SS

Watson T

Johnston DL

. The origin of the long head of the biceps from the scapula and glenoid labrum. J Bone Joint Surg Br. 1994;76:951-954.

31.

Walch G

Boileau P

Noel E

Donell ST

. Impingement of the deep surface of the supraspinatus tendon on the posterosuperior glenoid rim: an arthroscopic study. J Shoulder Elbow Surg. 1992;1:238-245.

32.

Yergason RM

. Supination sign. J Bone Joint Surg. 1931;13:160.

33.

Yoneda M

Hirooka A

Saito S

Yamamoto T

Ochi T

Shino K

. Arthroscopic stapling for detached superior glenoid labrum. J Bone Joint Surg Br. 1991;73:746-750.

Sports Activity After Arthroscopic Superior Labral Repair Using Suture Anchors in Overhead-Throwing Athletes

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