3 Surgical Treatments for a SLAP Tear of the Shoulder

Surgery is among the treatment options for a superior labrum from anterior to posterior (SLAP) tear, a type of shoulder joint injury. While outcomes are generally good after SLAP tear surgery, most people improve with non-surgical treatments.

If you've had a SLAP tear, you will be advised to rest after your injury to allow the inflammation to subside. This may help to alleviate your symptoms.

Common treatments for a SLAP tear include:

• Physical Therapy
• Anti-inflammatory Medications
• Cortisone Injections

If your symptoms persist despite these treatments, your doctor might recommend that you have minimally invasive arthroscopic surgery, with a small incision in your shoulder.

Surgery for a SLAP Tear

There are several different surgical procedures that can help you recover after a SLAP tear. Since SLAP tears often occur in conjunction with other shoulder problems, such as rotator cuff tears or shoulder arthritis, your surgical planning may have to take these factors into account.

The primary surgical options for the SLAP tear are:

• Debridement of the SLAP tear: During this procedure, your surgeon would shave away the torn portion of the labrum to leave a smooth edge. This option is only suitable for minor tears that do not involve the biceps tendon. The biceps anchor, which is the portion of the biceps tendon within the shoulder joint, must be stable for a debridement surgery to be effective. If the biceps anchor is not secure, debridement of the torn portion of the labrum is unlikely to alleviate symptoms. Recovery following an isolated debridement is faster than recovery after a surgical repair.
• SLAP Repair: During this arthroscopic procedure, your surgeon would use suture anchors to reattach your torn labrum to the bone of your shoulder socket. The anchor is seated into the bone, and the sutures are wrapped around the labrum and tied snugly to the bone. A SLAP repair is best suited for people who want to remain active and who have an otherwise healthy shoulder. 
• Biceps Tenodesis: During this procedure, the biceps tendon is cut from where it attaches to the labrum and reinserted in another area. When the forces that pull on the SLAP region are reduced, the symptoms can be alleviated. A biceps tenodesis is a common surgical choice for people who are over 40 years of age or those who have associated biceps tendonitis or tearing. A biceps tenodesis can be done arthroscopically. The best technique for a biceps tenodesis procedure depends primarily on other conditions being treated within the shoulder joint.

Results of Surgery

The results of different surgical procedures have been reported in a number of scientific studies. 

The most commonly studied surgical procedure is the SLAP repair. In patients having an arthroscopic SLAP repair using modern suture anchors, more than 90% are found to have good results, and more than 85% are able to return to competitive athletic activities.

Risks of surgical treatment include the usual risks of arthroscopic shoulder surgery. These may include infection, stiffness, and/or shoulder weakness. Your recovery from surgery can be affected if you also have had other shoulder injuries in addition to the SLAP tear.

The Attachment

SLAP tears are a common cause of shoulder discomfort, especially for athletes who have frequent overhead movements. Often, a SLAP tear can be managed with nonsurgical treatments, especially if you can rest the joint long enough for it to heal.

However, when nonsurgical treatment doesn't adequately alleviate symptoms, surgical treatment of the SLAP tear can be considered. There are several surgical options for the treatment of a SLAP tear, each with advantages and disadvantages. Selection of the right surgery can help to ensure a successful treatment outcome.