Effectiveness of Biceps Tenodesis Versus SLAP Repair for Surgical Treatment of Isolated SLAP Lesions: A Systemic Review and Meta-analysis

Overview

Journal J Orthop Translat

Publisher Elsevier

Specialty Orthopedics

Date 2019 Feb 7

PMID 30723678

Citations 12

Authors

Min Li

Atik Badshah Shaikh

Jinbo Sun

Peng Shang

Xiliang Shang

Affiliations

Soon will be listed here.

Abstract

Background: Type II superior labrum anterior and posterior (SLAP) lesions could induce chronic shoulder pain and impaired movement. Current management of Type II SLAP lesions consists of two well-established surgical procedures: arthroscopic biceps tenodesis and SLAP repair. However, which technique is preferred over the other is still a controversy.

Methods: We performed a systematic electronic database search on Cochrane Central Register of Controlled Trials, MEDLINE and Embase to identify articles equating superior labral repair with biceps tenodesis, which were reported before August 2017 which included the phrase "superior labral anterior posterior" or "SLAP." The randomised controlled clinical trials that met our criteria were evaluated for quality of methodology. The results obtained were further analysed and correlated to present the benefits and drawbacks comparing the two SLAP repair surgical procedures.

Result: Based on our inclusion and exclusion criteria, we identified five articles (204 patients) that were included in this meta-analysis. The results indicate that prevalence of patients return to preinjury sports level and the patients satisfaction were found to be significantly better in tenodesis group than in the SLAP repair group ( < 0.05). As for the patient age, VAS score, American Shoulder and Elbow Surgeons score, University of California at Los Angeles score, postoperative stiffness and reoperation rates, no significant differences were evident among the two groups, thus supporting the results reported in the current literatures ( > 0.05).

Conclusions: Both the surgical treatments, SLAP repair and the biceps tenodesis, are efficacious in pain alleviation and recovery of shoulder function. But, compared with SLAP repair, biceps tenodesis showed higher rate of patient satisfaction and return to preinjury sports participation.

The Translational Potential Of This Article: Impart better understanding regarding discrepancies in the outcomes between biceps tenodesis and SLAP repair in treating patients with isolated Type II SLAP lesions.

Citing Articles

Pulley ring suture increases shoulder stability after biceps tendon transposition.

Zhang D, Wu J, Zhang L, Chen Q, Wang C, Cai M Front Surg. 2025; 12:1437814.

PMID: 40066277 PMC: 11891159. DOI: 10.3389/fsurg.2025.1437814.

Basics of Shoulder Arthroscopy Part II: Diagnostic Arthroscopy in the Beach-Chair Position.

Ulrich M, Meta F, Tagliero A, Camp C Arthrosc Tech. 2024; 13(10):103083.

PMID: 39479046 PMC: 11519964. DOI: 10.1016/j.eats.2024.103083.

Image-Based Numerical Analysis for Isolated Type II SLAP Lesions in Shoulder Abduction and External Rotation.

Maldonado J, Puentes D, Quintero I, Gonzalez-Estrada O, Villegas D Diagnostics (Basel). 2023; 13(10).

PMID: 37238302 PMC: 10216909. DOI: 10.3390/diagnostics13101819.

Transtendon technique versus repair after completion of the tear for articular-sided partial rotator cuff tear: a meta-analysis of comparative studies.

Yang Y, Hu D, Chen S, Guan S, Shang X J Orthop Surg Res. 2023; 18(1):378.

PMID: 37217901 PMC: 10204267. DOI: 10.1186/s13018-023-03831-4.

Return to Sport and Patient-Reported Outcomes After Subpectoral Biceps Tenodesis for SLAP Tear in Collegiate Gymnasts.

Ulrich M, Cvetanovich G, Meeks B, Jones G Orthop J Sports Med. 2023; 11(5):23259671231159354.

PMID: 37152551 PMC: 10161309. DOI: 10.1177/23259671231159354.

References

Erickson J, Lavery K, Monica J, Gatt C, Dhawan A . Surgical treatment of symptomatic superior labrum anterior-posterior tears in patients older than 40 years: a systematic review. Am J Sports Med. 2014; 43(5):1274-82. DOI: 10.1177/0363546514536874. View

Patterson B, Creighton R, Spang J, Roberson J, Kamath G . Surgical Trends in the Treatment of Superior Labrum Anterior and Posterior Lesions of the Shoulder: Analysis of Data From the American Board of Orthopaedic Surgery Certification Examination Database. Am J Sports Med. 2014; 42(8):1904-10. DOI: 10.1177/0363546514534939. View

Boileau P, Parratte S, Chuinard C, Roussanne Y, Shia D, Bicknell R . Arthroscopic treatment of isolated type II SLAP lesions: biceps tenodesis as an alternative to reinsertion. Am J Sports Med. 2009; 37(5):929-36. DOI: 10.1177/0363546508330127. View

Huri G, Hyun Y, Garbis N, McFarland E . Treatment of superior labrum anterior posterior lesions: a literature review. Acta Orthop Traumatol Turc. 2014; 48(3):290-7. DOI: 10.3944/AOTT.2014.3169. View

Zhao C, Hu J, Kong M, Qiu B, Gu H, Zhang S . [Case-control study on superior labrum from anterior to posterior repair and biceps tenodesis for the treatment of type II SLAP injury]. Zhongguo Gu Shang. 2015; 28(6):531-5. View

Neri B, Vollmer E, Kvitne R . Isolated type II superior labral anterior posterior lesions: age-related outcome of arthroscopic fixation. Am J Sports Med. 2009; 37(5):937-42. DOI: 10.1177/0363546508328417. View

Erickson B, Jain A, Abrams G, Nicholson G, Cole B, Romeo A . SLAP Lesions: Trends in Treatment. Arthroscopy. 2016; 32(6):976-81. DOI: 10.1016/j.arthro.2015.11.044. View

Denard P, Ladermann A, Burkhart S . Long-term outcome after arthroscopic repair of type II SLAP lesions: results according to age and workers' compensation status. Arthroscopy. 2012; 28(4):451-7. DOI: 10.1016/j.arthro.2011.09.005. View

Kim S, Ha K, Kim S . Results of arthroscopic treatment of superior labral lesions. J Bone Joint Surg Am. 2002; 84(6):981-5. DOI: 10.2106/00004623-200206000-00012. View

10.

Cohen D, Coleman S, Drakos M, Allen A, OBrien S, Altchek D . Outcomes of isolated type II SLAP lesions treated with arthroscopic fixation using a bioabsorbable tack. Arthroscopy. 2006; 22(2):136-42. DOI: 10.1016/j.arthro.2005.11.002. View

11.

Ide J, Maeda S, Takagi K . Sports activity after arthroscopic superior labral repair using suture anchors in overhead-throwing athletes. Am J Sports Med. 2005; 33(4):507-14. DOI: 10.1177/0363546504269255. View

12.

Schroder C, Skare O, Gjengedal E, Uppheim G, Reikeras O, Brox J . Long-term results after SLAP repair: a 5-year follow-up study of 107 patients with comparison of patients aged over and under 40 years. Arthroscopy. 2012; 28(11):1601-7. DOI: 10.1016/j.arthro.2012.02.025. View

13.

Friel N, Karas V, Slabaugh M, Cole B . Outcomes of type II superior labrum, anterior to posterior (SLAP) repair: prospective evaluation at a minimum two-year follow-up. J Shoulder Elbow Surg. 2010; 19(6):859-67. PMC: 3869567. DOI: 10.1016/j.jse.2010.03.004. View

14.

Kanatli U, Yagmur Ozturk B, Bolukbasi S . Arthroscopic repair of type II superior labrum anterior posterior (SLAP) lesions in patients over the age of 45 years: a prospective study. Arch Orthop Trauma Surg. 2011; 131(8):1107-13. DOI: 10.1007/s00402-011-1348-8. View

15.

Schroder C, Skare O, Reikeras O, Mowinckel P, Brox J . Sham surgery versus labral repair or biceps tenodesis for type II SLAP lesions of the shoulder: a three-armed randomised clinical trial. Br J Sports Med. 2017; 51(24):1759-1766. PMC: 5754846. DOI: 10.1136/bjsports-2016-097098. View

16.

Yung P, Fong D, Kong M, Lo C, Fung K, Ho E . Arthroscopic repair of isolated type II superior labrum anterior-posterior lesion. Knee Surg Sports Traumatol Arthrosc. 2008; 16(12):1151-7. DOI: 10.1007/s00167-008-0629-4. View

17.

Andrews J, Carson Jr W, McLeod W . Glenoid labrum tears related to the long head of the biceps. Am J Sports Med. 1985; 13(5):337-41. DOI: 10.1177/036354658501300508. View

18.

Gorantla K, Gill C, Wright R . The outcome of type II SLAP repair: a systematic review. Arthroscopy. 2010; 26(4):537-45. DOI: 10.1016/j.arthro.2009.08.017. View

19.

Katz L, Hsu S, Miller S, Richmond J, Khetia E, Ketia E . Poor outcomes after SLAP repair: descriptive analysis and prognosis. Arthroscopy. 2009; 25(8):849-55. DOI: 10.1016/j.arthro.2009.02.022. View

20.

Weber S, Martin D, Seiler 3rd J, Harrast J . Superior labrum anterior and posterior lesions of the shoulder: incidence rates, complications, and outcomes as reported by American Board of Orthopedic Surgery. Part II candidates. Am J Sports Med. 2012; 40(7):1538-43. DOI: 10.1177/0363546512447785. View