Systematic Review
The Outcome of Type II SLAP Repair: A Systematic Review

https://doi.org/10.1016/j.arthro.2009.08.017Get rights and content

Purpose

The purpose of this study was to systematically review the literature regarding the outcome of arthroscopic repair of type II SLAP lesions in order to assess the effectiveness of current methods of treatment.

Methods

We performed a systematic review of the results of repair of type II SLAP lesions. Inclusion criteria included outcome studies of repair of type II SLAP lesions with minimum 2-year follow-up and Level IV evidence or higher published in the English language in peer-reviewed journals.

Results

There is no Level I or II evidence for SLAP repair outcome. Regarding the general outcome after type II SLAP repair, the percentage of good and excellent results ranged from 40% to 94%. Return to previous level of play ranged from 20% to 94%. Overhead athletes are the most challenging to return to the previous level of performance for this diagnosis, and their return rate reflects this. Five studies reported these results, and the rate of return ranged from 22% to 64% for baseball players.

Conclusions

Arthroscopic repair of type II SLAP tears results in overall excellent results for individuals not involved in throwing or overhead sports. The results of type II SLAP repair in throwing or overhead athletes are much less predictable. Future studies should be prospective in nature and at least use a longitudinal prospective cohort design to determine predictors of outcome.

Level of Evidence

Level IV, systematic review of Level III and IV studies.

Section snippets

Methods

We performed a systematic review of the results of repair of type II SLAP lesions. Inclusion criteria included outcome studies of repair of type II SLAP lesions with minimum 2-year follow-up. Additional inclusion criteria included English-language studies with Level IV or higher evidence published in peer-reviewed journals. Exclusion criteria included any labral tear other than a type II SLAP tear; treatment that consisted of simple debridement; treatment associated with full-thickness rotator

Results

The search performed on July 26, 2009, yielded 77 studies that met the first-pass inclusion criteria. Abstracts were reviewed, resulting in 39 articles that were retrieved and reviewed. Full-text review resulted in 12 studies that met the inclusion/exclusion criteria and were included in this systematic review (Table 1). Two authors (K.G. and R.W.W.) independently performed quality appraisal, and potential flaws and biases were identified.

In 1991 Yoneda et al.,9 in a Level IV retrospective case

Discussion

A type II SLAP tear is an injury that commonly afflicts active individuals. It has been noted to cause significant issues for overhead-throwing athletes, particularly baseball pitchers. We have systematically reviewed the literature to evaluate the outcome of type II SLAP repair and identified 12 studies that met the inclusion/exclusion criteria. In general, depending on outcome measured, type II SLAP repair resulted in reasonable overall successful outcomes. However, the majority of studies

Conclusions

After this systematic review of the results of a series of Level III and IV studies, we conclude that arthroscopic repair of type II SLAP tears results in overall excellent results for individuals not involved in throwing or overhead sports. This is even true in patients with significant pathology treated concomitantly. The results of type II SLAP repair in throwing or overhead athletes are much less predictable. Although some of these athletes have successful outcomes, the rate is typically

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    The authors report no conflict of interest.

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