Return to Sport at Preinjury Level is Common After Surgical Treatment of SLAP Lesions: A Systematic Review and a Meta-analysis.
Journal
Sports medicine and arthroscopy review
ISSN: 1538-1951
Titre abrégé: Sports Med Arthrosc Rev
Pays: United States
ID NLM: 9315689
Informations de publication
Date de publication:
01 Mar 2024
01 Mar 2024
Historique:
medline:
2
5
2024
pubmed:
2
5
2024
entrez:
2
5
2024
Statut:
ppublish
Résumé
Patients undergoing surgery for Superior-Labrum-anterior-to-posterior (SLAP) lesions are often worried about their return to sport performance. This systematic review determined the rate of return to sport and return to sport at the previous level (RTSP) after surgery for SLAP lesion. The PRISMA guidelines were followed. Meta-analysis of data through forest plot projections was conducted. Studies were divided and analyzed according to the type of interventions (isolated slap repair or SLAP repair with rotator cuff debridement and biceps tenodesis). The mean overall rate of return to sport after the procedures was 90.6% and the mean overall rate of return to sport at the previous level after the procedures was 71.7%. RTSP rates of the whole population were 71% (95% CI: 60%-80%), 66% (95% CI: 49%-79%), and 78% (95% CI: 67%-87%) for isolated SLAP repair, SLAP repair with the rotator cuff debridement and biceps tenodesis, respectively. A lack of subgroup analysis for the specific performance demand or type of lesion related to the surgical technique used might induce a high risk of bias. Return to sports at the previous level after surgically treated superior labrum anterior to posterior lesion is possible and highly frequent, with the highest rates of RTSP in patients treated with biceps tenodesis. More studies and better-designed trials are needed to enrich the evidence on indications of SLAP surgical treatment in relation to specific sports-level demand. Level-IV.
Sections du résumé
BACKGROUND
BACKGROUND
Patients undergoing surgery for Superior-Labrum-anterior-to-posterior (SLAP) lesions are often worried about their return to sport performance. This systematic review determined the rate of return to sport and return to sport at the previous level (RTSP) after surgery for SLAP lesion.
MATERIALS AND METHODS
METHODS
The PRISMA guidelines were followed. Meta-analysis of data through forest plot projections was conducted. Studies were divided and analyzed according to the type of interventions (isolated slap repair or SLAP repair with rotator cuff debridement and biceps tenodesis).
RESULTS
RESULTS
The mean overall rate of return to sport after the procedures was 90.6% and the mean overall rate of return to sport at the previous level after the procedures was 71.7%. RTSP rates of the whole population were 71% (95% CI: 60%-80%), 66% (95% CI: 49%-79%), and 78% (95% CI: 67%-87%) for isolated SLAP repair, SLAP repair with the rotator cuff debridement and biceps tenodesis, respectively. A lack of subgroup analysis for the specific performance demand or type of lesion related to the surgical technique used might induce a high risk of bias.
DISCUSSION
CONCLUSIONS
Return to sports at the previous level after surgically treated superior labrum anterior to posterior lesion is possible and highly frequent, with the highest rates of RTSP in patients treated with biceps tenodesis. More studies and better-designed trials are needed to enrich the evidence on indications of SLAP surgical treatment in relation to specific sports-level demand.
LEVEL OF EVIDENCE
METHODS
Level-IV.
Identifiants
pubmed: 38695497
doi: 10.1097/JSA.0000000000000383
pii: 00132585-202403000-00002
doi:
Types de publication
Systematic Review
Journal Article
Meta-Analysis
Langues
eng
Sous-ensembles de citation
IM
Pagination
2-11Informations de copyright
Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
Disclosure: The authors declare no conflicts of interest.
Références
Grossman MG, Tibone JE, McGarry MH, et al. A cadaveric model of the throwing shoulder: a possible etiology of superior labrum anterior-to-posterior lesions. J Bone Joint Surg Am. 2005;87:824–831.
Funk L, Snow M. SLAP tears of the glenoid labrum in contact athletes. Clin J Sport Med. 2007;17:1–4.
Edwards SL, Lee JA, Bell JE, et al. Nonoperative treatment of superior labrum anterior posterior tears: improvements in pain, function, and quality of life. Am J Sports Med. 2010;38:1456–1461.
Friel NA, Karas V, Slabaugh MA, et al. 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;19:859–867.
Neuman BJ, Boisvert CB, Reiter B, et al. Results of arthroscopic repair of type II superior labral anterior posterior lesions in overhead athletes: assessment of return to preinjury playing level and satisfaction. Am J Sports Med. 2011;39:1883–1888.
Katz LM, Hsu S, Miller SL, et al. Poor outcomes after SLAP repair: Descriptive analysis and prognosis. Arthroscopy. 2009;25:849–855.
Provencher MT, McCormick F, Dewing C, et al. A prospective analysis of 179 type 2 superior labrum anterior and posterior repairs: outcomes and factors associated with success and failure. Am J Sports Med. 2013;41:880–886.
Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ. 2009;339:b2535.
Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33:159–174.
Slim K, Nini E, Forestier D, et al. Methodological index for non-randomized studies (minors): development and validation of a new instrument. ANZ J Surg. 2003;73:712–716.
Abdul-Rassoul H, Defazio M, Curry EJ, et al. Return to sport after the surgical treatment of superior labrum anterior to posterior tears: a systematic review. Orthop J Sports Med. 2019;7:2325967119841892.
Freijomil N, Peters S, Millay A, et al. The success of return to sport after superior labrum anterior to posterior (slap) tears: a systematic review and meta-analysis. Int J Sports Phys Ther. 2020;15:659–670.
Sciascia A, Myers N, Kibler WB, et al. Return to preinjury levels of participation after superior labral repair in overhead athletes: a systematic review. J Athl Train. 2015;50:767–777.
Denard PJ, Ladermann A, Parsley BK, et al. Arthroscopic biceps tenodesis compared with repair of isolated type II SLAP lesions in patients older than 35 years. Orthopedics. 2014;37:e292–e297.
Ulrich MN, Cvetanovich GL, Meeks BD, et al. Return to sport and patient-reported outcomes after subpectoral biceps tenodesis for SLAP tear in collegiate gymnasts. Orthop J Sports Med. 2023;11:23259671231159354.
Gilliam BD, Douglas L, Fleisig GS, et al. Return to play and outcomes in baseball players after superior labral anterior-posterior repairs. Am J Sports Med. 2018;46:109–115.
Thayaparan A, Yu J, Horner NS, et al. Return to sport after arthroscopic superior labral anterior-posterior repair: a systematic review. Sports Health. 2019;11:520–527.
Samani JE, Marston SB, Buss DD. Arthroscopic stabilization of type II SLAP lesions using an absorbable tack. Arthroscopy. 2001;17:19–24.
Kim SH, Ha KI, Kim SH, et al. Results of arthroscopic treatment of superior labral lesions. J Bone Joint Surg Am. 2002;84:981–985.
O’Brien SJ, Allen AA, Coleman SH, et al. The trans-rotator cuff approach to SLAP lesions: technical aspects for repair and a clinical follow-up of 31 patients at a minimum of 2 years. Arthroscopy. 2002;18:372–377.
Rhee YG, Lee DH, Lim CT. Unstable isolated SLAP lesion: Clinical presentation and outcome of arthroscopic fixation. Arthroscopy. 2005;21:1099.
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;33:507–514.
Cohen DB, Coleman S, Drakos MC, et al. Outcomes of isolated type II SLAP lesions treated with arthroscopic fixation using a bioabsorbable tack. Arthroscopy. 2006;22:136–142.
Enad JG, Gaines RJ, White SM, et al. Arthroscopic superior labrum anterior-posterior repair in military patients. J Shoulder Elbow Surg. 2007;16:300–305.
Yung PS, Fong DT, Kong MF, et al. Arthroscopic repair of isolated type II superior labrum anterior-posterior lesion. Knee Surg Sports Traumatol Arthrosc. 2008;16:1151–1157.
Boileau P, Parratte S, Chuinard C, et al. Arthroscopic treatment of isolated type II SLAP lesions: biceps tenodesis as an alternative to reinsertion. Am J Sports Med. 2009;37:929–936.
Brockmeier SF, Voos JE, Williams RJ III, et al. Outcomes after arthroscopic repair of type-II SLAP lesions. J Bone Joint Surg Am. 2009;91:1595–1603.
Oh JH, Lee HK, Kim JY, et al. Clinical and radiologic outcomes of arthroscopic glenoid labrum repair with the BioKnotless suture anchor. Am J Sports Med. 2009;37:2340–2348.
Kaisidis A, Pantos P, Heger H, et al. Arthroscopic fixation of isolated type II SLAP lesions using a two-portal technique. Acta Orthop Belg. 2011;77:160–166.
Boesmueller S, Mayerhofer S, Huf W, et al. Short-term clinical results after arthroscopic type II SLAP repair. Wien Klin Wochenschr. 2012;124:370–376.
Denard PJ, Ladermann A, Burkhart SS. Long-term outcome after arthroscopic repair of type II SLAP lesions: results according to age and workers’ compensation status. Arthroscopy. 2012;28:451–457.
Maier D, Jaeger M, Ogon P, et al. Suture anchors or transglenoidal sutures for arthroscopic repair of isolated SLAP-2 lesions? A matched-pair comparison of functional outcome and return to sports. Arch Orthop Trauma Surg. 2013;133:227–235.
Park JY, Chung SW, Jeon SH, et al. Clinical and radiological outcomes of type 2 superior labral anterior posterior repairs in elite overhead athletes. Am J Sports Med. 2013;41:1372–1379.
Fedoriw WW, Ramkumar P, McCulloch PC, et al. Return to play after treatment of superior labral tears in professional baseball players. Am J Sports Med. 2014;42:1155–1160.
Ek ET, Shi LL, Tompson JD, et al. Surgical treatment of isolated type II superior labrum anterior-posterior (SLAP) lesions: repair versus biceps tenodesis. J Shoulder Elbow Surg. 2014;23:1059–1065.
McCormick F, Nwachukwu BU, Solomon D, et al. The efficacy of biceps tenodesis in the treatment of failed superior labral anterior posterior repairs. Am J Sports Med. 2014;42:820–825.
Gottschalk MB, Karas SG, Ghattas TN, et al. Subpectoral biceps tenodesis for the treatment of type II and IV superior labral anterior and posterior lesions. Am J Sports Med. 2014;42:2128–2135.
Chalmers PN, Monson B, Frank RM, et al. Combined SLAP repair and biceps tenodesis for superior labral anterior-posterior tears. Knee Surg Sports Traumatol Arthrosc. 2016;24:3870–3876.
Waterman BR, Arroyo W, Heida K, et al. SLAP repairs with combined procedures have lower failure rate than isolated repairs in a military population: Surgical outcomes with minimum 2-year follow-up. Orthop J Sports Med. 2015;3:2325967115599154.
Beyzadeoglu T, Circi E. Superior labrum anterior posterior lesions and associated injuries: return to play in elite athletes. Orthop J Sports Med. 2015;3:2325967115577359.
Smith R, Lombardo DJ, Petersen-Fitts GR, et al. Return to play and prior performance in major league baseball pitchers after repair of superior labral anterior-posterior tears. Orthop J Sports Med. 2016;4:2325967116675822.
Rangavajjula A, Hyatt A, Raneses E, et al. Return to play after treatment of shoulder labral tears in professional hockey players. Phys Sportsmed. 2016;44:119–125.
Boesmueller S, Tiefenboeck TM, Hofbauer M, et al. Progression of function and pain relief as indicators for returning to sports after arthroscopic isolated type II SLAP repair-a prospective study. BMC Musculoskelet Disord. 2017;18:257.
Pogorzelski J, Horan MP, Hussain ZB, et al. Subpectoral biceps tenodesis for treatment of isolated type II SLAP lesions in a young and active population. Arthroscopy. 2018;34:371–376.
Fourman MS, Arner JW, Bayer S, et al. Type VIII SLAP Repair at midterm follow-up: throwers have greater pain, decreased function, and poorer return to play. Arthroscopy. 2018;34:3159–3164.
Dunne KF, Knesek M, Tjong VK, et al. Arthroscopic treatment of type II superior labral anterior to posterior (SLAP) lesions in a younger population: minimum 2-year outcomes are similar between SLAP repair and biceps tenodesis. Knee Surg Sports Traumatol Arthrosc. 2021;29:257–265.
Carbone S, Castagna V, Passaretti D, et al. Supraspinatus repair and biceps tenodesis in competitive CrossFit athletes allow for a 100% of return to sport. Knee Surg Sports Traumatol Arthrosc. 2021;29:3929–3935.
Takeuchi Y, Sugaya H, Takahashi N, et al. Superior labral injuries in elite gymnasts: symptoms, pathology, and outcomes after surgical repair. Orthop J Sports Med. 2020;8:2325967120935001.