Arthroscopy: The Journal of Arthroscopic and Related Surgery
Volume 25, Issue 12 , Pages 1374-1379 , December 2009

The Passive Distraction Test: A New Diagnostic Aid for Clinically Significant Superior Labral Pathology

  • John A. Schlechter, D.O.

      Affiliations

    • Department of Orthopaedic Surgery, Children's Hospital Orange County, Orange, California, U.S.A.
    • ,
  • Stacy Summa, P.A.-C.

      Affiliations

    • Orthopedic Specialty Institute, Orange, California, U.S.A.
    • ,
  • Benjamin D. Rubin, M.D.

      Affiliations

    • Orthopedic Specialty Institute, Orange, California, U.S.A.
    • Corresponding Author InformationAddress correspondence and reprint requests to Ben Rubin, M.D., 280 S Main St, Suite 200, Orange, CA 92868, U.S.A.

Received 7 November 2008 ,Accepted 23 April 2009.

References 

  1. Andrews JR, Carson WG, McLeod WD. Glenoid labrum tears related to the long head of the biceps. Am J Sports Med. 1985;13:337–341
  2. Snyder SJ, Karzel RP, Del Pizzo W, Ferkel RD, Friedman MJ. SLAP lesions of the shoulder. Arthroscopy. 1990;6:274–279
  3. Wilk KE, Reinold MM, Dugas JR, Arrigo CA, Moser MW, Andrews JR. Current concepts in the recognition and treatment of superior labral (SLAP) lesions. J Orthop Sports Phys Ther. 2005;35:273–291
  4. Romeo AA, Cole B, Verma M. SLAP lesions. Presented at the Arthroscopy Association of North America Fall Course, New Orleans, LA, November 2003.
  5. Parentis MA, Mohr KJ, ElAttrache NS. Disorders of the superior labrum: Review and treatment guidelines. Clin Orthop Relat Res. 2002;(400):77–87
  6. Musgrave DS, Rodosky MW. SLAP lesions: Current concepts. Am J Orthop. 2001;30:29–38
  7. Mileski RA, Snyder SJ. Superior labral lesions in the shoulder: Pathoanatomy and surgical management. J Am Acad Orthop Surg. 1998;6:121–131
  8. Kim TK, Queale WS, Cosgarea AJ, McFarland EG. Clinical features of the different types of SLAP lesions: An analysis of one hundred and thirty-nine cases (Superior labrum anterior posterior). J Bone Joint Surg Am. 2003;85:66–71
  9. Holtby R, Razmjou H. Accuracy of the Speed's and Yergason's tests in detecting biceps pathology and SLAP lesions: Comparison with arthroscopic findings. Arthroscopy. 2004;20:231–236
  10. Handelberg F, Willems S, Shahabpour M, Huskin JP, Kuta J. SLAP lesions: A retrospective multicenter study. Arthroscopy. 1998;14:856–862
  11. Burkhart SS, Morgan CD, Kibler WB. The disabled throwing shoulder: Spectrum of pathology (Part I: Pathoanatomy and biomechanics). Arthroscopy. 2003;19:404–420
  12. Burkhart SS, Morgan CD, Kibler WB. Shoulder injuries in overhead athletes (The “dead arm” revisited). Clin Sports Med. 2000;19:125–158
  13. 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
  14. Burkhart SS, Morgan C. SLAP lesions in the overhead athlete. Orthop Clin North Am. 2001;32:431–441viii
  15. Maffet MW, Gartsman GM, Moseley B. Superior labrum-biceps tendon complex lesions of the shoulder. Am J Sports Med. 1995;23:93–98
  16. O'Brien SJ, Pagnani MJ, Fealy S, McGlynn SR, Wilson JB. The active compression test: A new and effective test for diagnosing labral tears and acromioclavicular joint abnormality. Am J Sports Med. 1998;26:610–613
  17. Kibler WB. Specificity and sensitivity of the anterior slide test in throwing athletes with superior glenoid labral tears. Arthroscopy. 1995;11:296–300
  18. Kim SH, Ha KI, Ahn JH, Choi HJ. Biceps load test II: A clinical test for SLAP lesions of the shoulder. Arthroscopy. 2001;17:160–164
  19. Mimori K, Muneta T, Nakagawa T, Shinomiya K. A new pain provocation test for superior labral tears of the shoulder. Am J Sports Med. 1999;27:137–142
  20. Myers TH, Zemanovic JR, Andrews JR. The resisted supination external rotation test: A new test for the diagnosis of superior labral anterior posterior lesions. Am J Sports Med. 2005;33:1315–1320
  21. Liu SH, Henry MH, Nuccion SL. A prospective evaluation of a new physical examination in predicting glenoid labral tears. Am J Sports Med. 1996;24:721–725
  22. Ebinger N, Magosch P, Lichtenberg S, Habermeyer P. A new SLAP test: The supine flexion resistance test. Arthroscopy. 2008;24:500–505
  23. Stetson WB, Templin K. The crank test, the O'Brien test, and routine magnetic resonance imaging scans in the diagnosis of labral tears. Am J Sports Med. 2002;30:806–809
  24. McFarland EG, Kim TK, Savino RM. Clinical assessment of three common tests for superior labral anterior-posterior lesions. Am J Sports Med. 2002;30:810–815
  25. Guanche CA, Jones DC. Clinical testing for tears of the glenoid labrum. Arthroscopy. 2003;19:517–523
  26. Oh JH, Kim JY, Kim WS, Gong HS, Lee JH. The evaluation of various physical examinations for the diagnosis of type II superior labrum anterior and posterior lesion. Am J Sports Med. 2008;36:353–359
  27. Dessaur WA, Magarey ME. Diagnostic accuracy of clinical tests for superior labral anterior posterior lesions: A systematic review. J Orthop Sports Phys Ther. 2008;38:341–352
  28. Gobezie R, Zurakowski D, Lavery K, Millett PJ, Cole BJ, Warner JJ. Analysis of interobserver and intraobserver variability in the diagnosis and treatment of SLAP tears using the Snyder classification. Am J Sports Med. 2008;36:1373–1379
  29. Rubin BD. Evaluation of the overhead athlete: Examination and ancillary testing. Arthroscopy. 2003;19(Suppl 1):42–46
  30. Savoie FH, Field LD, Atchinson S. Anterior superior instability with rotator cuff tearing: SLAC lesion. Orthop Clin North Am. 2001;32:457–461ix
  31. Snyder SJ, Banas MP, Karzel RP. An analysis of 140 injuries to the superior glenoid labrum. J Shoulder Elbow Surg. 1995;4:243–248
  32. Davidson PA, Rivenburgh DW. Mobile superior glenoid labrum: A normal variant or pathologic condition?. Am J Sports Med. 2004;32:962–966

 The authors report no conflict of interest.

PII: S0749-8063(09)00419-8

doi: 10.1016/j.arthro.2009.04.070

Arthroscopy: The Journal of Arthroscopic and Related Surgery
Volume 25, Issue 12 , Pages 1374-1379 , December 2009

Article Tools

* Image Usage & Resolution