Your shoulder joint is a ball and socket joint made up of the upper arm bone, the shoulder blade and the collarbone. The head of the upper arm bone fits into the socket of the shoulder joint known as the glenoid cavity. The outer edge of the glenoid is surrounded by a strong fibrous tissue called the labrum.
A superior labrum anterior and posterior tear or SLAP tear is an injury to the labrum. This injury may also involve the biceps tendon, which is attached to the top part of the labrum. The injury occurs from repeated use of the shoulder while throwing or a fall onto the shoulder. A SLAP tear can be treated through an arthroscopic surgical procedure called a SLAP repair.
What are the indications for SLAP repair?
A SLAP repair is indicated to treat the torn labrum of the shoulder socket when conservative treatment measures such as NSAID’s (non-steroidal anti-inflammatory medications) and physical therapy do not relieve the symptoms of a SLAP tear.
How is the procedure performed?
A SLAP repair is a minimally invasive surgery using an arthroscope, a tube with a light and camera on the end that projects images onto a monitor for your surgeon to view inside your joint. The type of SLAP repair depends on the type of tear involved and will be determined once your surgeon views the joint. The procedure is performed under general anesthesia and nerve block.
- Your surgeon first makes small incisions to insert the arthroscope and thin surgical instruments into the shoulder joint.
- Your surgeon will then identify the type of SLAP tear and remove the damaged tissue of the labrum.
- A small hole is then drilled into the bone of the shoulder socket close to the labral tear.
- Your surgeon will place an anchor into the drilled hole along with a strong suture.
- Additional anchors can be placed as required for securing the torn labrum to the bone of the shoulder socket.
- Finally, the torn labrum is tied to the bone with the sutures.
What are the steps recommended for post-operative care?
After the procedure, your arm will be placed in a sling for the first 3 weeks to immobilize the shoulder joint and you will be advised to restrict active motion of your shoulder for about 6 weeks. You will be instructed take your pain medications and to apply ice packs to control swelling and pain. The plaster strips over the wounds should be kept dry until the wounds heal. Through physical therapy, you can slowly regain motion and strengthen the shoulder. You can resume sports activities after consulting with your physical therapist and surgeon. You should avoid driving for a few weeks after the surgery.
What are the advantages of SLAP repair?
A SLAP repair involves the reattaching of the labrum to its normal anatomical position; thereby restoring the anatomy of the shoulder. The procedure also allows normal functioning of the previously damaged labrum and biceps attachment.
What are the associated risks and complications?
As with any surgical procedure, SLAP repair involves certain potential risks and complications including
- Excessive bleeding
- Blood clots
- Shoulder stiffness
- Injury to nerves or blood vessels