Superior Labrum Anterior to Posterior (SLAP) Tears

In the shoulder there is a small bumper of tissue, called the labrum, which surrounds the socket. The labrum helps to keep the ball (humeral head) in its place within the socket. Superior labrum anterior to posterior (SLAP) tears are an injury to the top of the labrum on the socket. These tears are common in throwing athletes such as baseball pitchers but can occur in anyone after a traumatic injury to the shoulder. SLAP tears do not always need surgical treatment. The demands of the shoulder in a throwing athlete may make it difficult for these patients to return to their sport without surgery.

Surgical treatment is performed arthroscopically with the use of small anchors, typically made of absorbable plastic, placed along the rim of the shoulder socket. Sutures coming out of these anchors tie the labrum back to its proper location. Following surgery, the shoulder is held in a sling for up to 4 weeks with physical therapy to minimize the risk of shoulder stiffness. It usually takes 3-4 months of physical therapy to restore shoulder motion and strength following a SLAP repair.

Patients often have less pain and greater use of the shoulder following SLAP repair surgery. Return to sports, particularly for throwing athletes, varies widely from as low as 20% up to 84% depending on the study. Ongoing research is looking at ways of improving outcomes after SLAP repair, especially in throwing athletes.

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