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.

ArticleinArthroscopy The Journal of Arthroscopic and Related Surgery 28(11) · May 2012with27 Reads
Impact Factor: 3.21 · DOI: 10.1016/j.arthro.2012.02.025 · Source: PubMed
Abstract

PURPOSE: The aims of this prospective cohort study were to assess the long-term results after isolated superior labral repair and to determine whether the results were associated with age. METHODS: One hundred seven patients underwent repair of isolated SLAP tears. There were 36 women and 71 men with a mean age of 43.8 years (range, 20 to 68 years). Mean follow-up was 5.3 years (range, 4 to 8 years). Of the patients, 62 (57.9%) were aged 40 years or older. Follow-up examinations were performed by an independent examiner; 102 patients (95.3%) had a 5-year follow-up. RESULTS: The Rowe score improved from 62.8 (SD, 11.4) preoperatively to 92.1 (SD, 13.5) at follow-up (P < .001). Satisfaction was rated excellent/good for 90 patients (88%) at 5 years. There was no significant difference in the results for patients aged 40 years or older and those aged under 40 years. Difficulty with postoperative stiffness and pain was reported by 14 patients (13.1%). CONCLUSIONS: Our results suggest that long-term outcomes after isolated labral repair for SLAP lesions are good and independent of age. Postoperative stiffness was registered in 13.1% of the patients. LEVEL OF EVIDENCE: Level IV, therapeutic case series.

    • "In a 5-year follow-up study of arthroscopic repair in patients with SLAP lesions [8], the clinical Rowe Score (1988 version) was used as the main effect variable. This score has been reported to have considerable limitations [9] and results [8] would have been strengthened applying a self-report outcome with acceptable measurement properties. "
    [Show abstract] [Hide abstract] ABSTRACT: Having an estimate of the measurement error of self-report questionnaires is important both for assessing follow-up results after treatment and when planning intervention studies. Specific questionnaires have been evaluated for patients with shoulder instability, but not in particular for patients with SLAP (superior labral anterior posterior) lesions or recurrent dislocations. The aim of this study was to evaluate the agreement, reliability, and validity of two commonly questionnaires developed for patients with shoulder instability and a generic questionnaire in patients with SLAP lesions or recurrent anterior shoulder dislocations. Seventy-one patients were included, 33 had recurrent anterior dislocations and 38 had a SLAP lesion. The patients filled in the questionnaires twice at the same time of the day (+/- 2 hours) with a one week interval between administrations. We tested the Oxford Instability Shoulder Score (OISS) (range 12 to 60), the Western Ontario Shoulder Instability Index (WOSI) (0 to 2100), and the EuroQol: EQ-5D (-0.5 to 1.0) and EQ-VAS (0 to 100). Hypotheses were defined to test validity. ICC ranged from 0.89 (95 % CI 0.83 to 0.93) to 0.92 (0.87 to 0.95) for OISS, WOSI, and EQ-VAS and was 0.66 (0.50 to 0.77) for EQ-5D. The limits of agreement for the scores were: -7.8 to 8.4 for OISS; -339.9 to 344.8 for WOSI; -0.4 to 0.4 for EQ-5D; and -17.2 and 16.2 for EQ-VAS. All questionnaires reflect the construct that was measured. The correlation between WOSI and OISS was 0.73 and ranged from 0.49 to 0.54 between the shoulder questionnaires and the generic questionnaires. The divergent validity was acceptable, convergent validity failed, and known group validity was acceptable only for OISS. Measurement errors and limitations in validity should be considered when change scores of OISS and WOSI are interpreted in patients with SLAP lesions or recurrent shoulder dislocations. EQ-5D is not recommended as a single outcome.
    Full-text · Article · Jul 2013 · BMC Research Notes
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  • [Show abstract] [Hide abstract] ABSTRACT: Superior labral lesions are a common occurrence in athletes, but they also are seen in individuals who do not participate in athletics. The diagnosis and treatment of superior labrum anterior and posterior (SLAP) lesions pose a major challenge to anyone who evaluates shoulders, including orthopedic surgeons and rehabilitation specialists. One of the reasons the diagnosis is difficult to ascertain is that there are often coexisting abnormalities that can produce symptoms similar to those of SLAP lesions. Even though improvement in arthroscopic techniques has allowed arthroscopic repair of SLAP lesions with suture anchors, the surgical results, especially in athletes, have not proven to be as successful as once believed. This chapter reviews the anatomy, classification, pathophysiology, diagnosis, and treatment of SLAP lesions.
    No preview · Chapter · Jan 2013
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