Success rates of SLAP repair have been reported to be between 71% and 100%. However, a subset of patients have presented to our institution with residual pain and stiffness after SLAP repair. The purpose of this study is to identify the factors that led to SLAP repair failure in this subset of patients. We believe that in patients with SLAP lesions who are greater than 40 years of age and are not overhead athletes, the need for SLAP repair needs to carefully considered, as repair can lead to postoperative pain and stiffness.
A retrospective review was performed from 2000 to the present to identify patients with unsatisfactory outcomes after having undergone SLAP repair. Medical records were reviewed for demographic data, physical exam findings, and concomitant surgical procedures.
21 patients (20 males, 1 female) were identified at an average of 11 months (range 4.5 months to 25 months) post-operatively after SLAP repair. The average age of patients was 41 years (range 17 to 55 years). No patients were competitive overhead athletes. All patients presented with pain and stiffness. Compared to the contralateral shoulder, the average loss of motion was 41 degrees of forward flexion, 34 degrees of external rotation, and 25 degrees of internal rotation. 2 patients had concomitant rotator cuff repairs and 2 had concomitant Bankhart repairs. 9 patients improved after intra-articular cortisone injection and physical therapy, while 12 patients required revision arthroscopy, which included one or more of the following procedures: subacromial decompression, lysis of adhesions, biceps tenodesis, debridement of suture and anchor material.
The precise indications for SLAP repair remain unclear. In patients with SLAP lesions who are greater than 40 years of age and are not overhead athletes, the need for SLAP repair needs to carefully considered, as repair can lead to postoperative pain and stiffness.
© 2007 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.