While there is a high rate of satisfaction and return to play after arthroscopic superior-labrum anterior repair (SLAP), approximately 10% have revision surgery and only a modest percentage return to pre-operative play levels, according to a new study.
Could Arthroscopic SLAP Repair Be Improved? Absolutely.
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Secondary#returntoplay#shoulderinjury#slaptears
The study, “High Rate of Satisfaction and Return to Play at 5-Year Following Arthroscopic Superior-Labrum Anterior-Posterior Repairs,” was published online on February 03, 2022, in the journal Arthroscopy.
The researchers sought to evaluate the outcomes of patients 5-years post-operatively following arthroscopic superior-labrum anterior-posterior (SLAP) repair in a retrospective review.
They collected data on recurrence, Visual Analogue Scale score, Subjective Shoulder Value, American Shoulder & Elbow Surgeons score, and satisfaction. They also asked the patients about rate, level, and timing of return to play and whether they would have the same surgery again.
One hundred and twenty-two patients who underwent SLAP were included in the study. The majority of the patients were male with a mean age of 33.4 years. About 58.2% participated in a sport prior to surgery.
The mean follow-up was 86.4 ± 14.4 months. At the final follow up, the mean satisfaction was 8.7% and the mean Subjective Shoulder Value was 82.9.
The overall return to play rate was 85.9%, but only 64.8% returned at the same level at a mean of 10.5 ± 8 months. Thirteen patients needed further surgery, ten of which had biceps tenodesis.
Visual Analog Scale score during sport (p = 0.025), Subjective Shoulder Value (p < 0.001) and time to return to play (p = 0.0056) were each associated with higher satisfaction.
“There was a high rate of satisfaction at 5-year follow-up, with excellent patient reported outcomes but with a tenth of patients requiring revision surgeries. Additionally, while there was an overall high rate of return to play, there was only a modest rate of return to play at their pre-injury level and overhead athletes took longer to return to play,” the researchers wrote.
Study authors included Eoghan T. Hurley, Edward S. Mojica, Danielle H. Markus, Nathan A. Lorentz, Christopher A. Colasanti, M.D., Kirk A. Campbell, M.D., Micharl J. Alaia, M.D., and Laith M. Jazrawi, M.D., all of whom are affiliated with NYU Langone Health.
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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