A superior labral anterior and posterior lesion, commonly known as a SLAP lesion, is an injury to the labrum, the rim of cartilage that surrounds shoulder joint. The labrum forms a cup for the arm bone to move within, increasing shoulder stability. Injury to the labrum is often caused by a repetitive motion that pulls on the biceps tendon, or an acute type of trauma such as a shoulder dislocation or a fall with the arm stretched out. A SLAP lesion may also be caused by wear and tear in the superior labrum that occurs over time and generally appears in individuals over the age of 40. Patients with a SLAP lesion may experience pain with movement, limited range of motion, frequent dislocation and a catching sensation in the shoulder.
Treatment for a SLAP lesion may vary depending on the severity of the condition. SLAP lesions that cause only mild pain and discomfort may be treated with conservative measures such as non-steroidal anti-inflammatory medication or physical therapy. For those SLAP lesions that cause more severe pain, surgery is usually the most effective course of treatment.
The SLAP Repair Procedure
Surgery to repair a SLAP lesion is performed on an outpatient basis. General anesthesia is administered to the patient and in some cases a nerve block is used as well. These procedures can usually be performed arthroscopically through several small incisions into which a camera and tiny surgical instruments are inserted. Whether the surgical approach is arthroscopic or open, there are a number of ways to repair the damage to the labrum. The technique used may not be determined until the tear is visible to the surgeon and the procedure may include:
- Debridement of fraying tissue to prevent a tear
- Securing the loose labrum to the cup of the joint
- Repair or removing the torn labrum tissue
- Removing the labral tear and repairing the biceps tendon
The SLAP repair procedure generally takes approximately 90 minutes to complete.
Risks Of The SLAP Repair Procedure
While SLAP repair is considered a safe procedure with a very low incidence of complications, there are possible risks that may include:
- Blood clots
- Stiffness in the shoulder
- Nerve or blood vessel injury
There is also a risk that the patient may have a reaction to the anesthesia.
Recovery From The SLAP Repair Procedure
Patients may experience pain and mild swelling following the surgery. Medication is prescribed for pain and ice is applied to the site of repair to manage swelling. To support and protect the arm during the initial phase of healing, a sling will be worn for two to four weeks following the procedure. Physical therapy may be required for several months after surgery to ensure that the joint heals properly. Physical therapy can be quite effective in improving flexibility and regaining strength in the affected shoulder.
Most patients can return to sedentary jobs after a few weeks, but the timing will depend on both the severity of the damage and the individual’s progress in recovery. Sports and other physical activity can typically be resumed within four to eight months after surgery.