Literature DB >> 23177591

The effect on external rotation of an anchor placed anterior to the biceps in type 2 SLAP repairs in a cadaveric throwing model.

Patrick C McCulloch1, Wade J Andrews, Jerry Alexander, Adam Brekke, Salim Duwani, Philip Noble.   

Abstract

PURPOSE: This study examined whether there is a difference in external rotation (ER) between type 2 SLAP repairs consisting of anchors placed only posterior to the biceps insertion compared with repairs with an additional anchor placed anterior to the biceps.
METHODS: Seven cadaveric shoulders from donors with a mean age of 39.4 years were tested. Type 2 SLAP lesions were created, followed by a 3-anchor repair: a standard repair with 2 anchors posterior to the biceps plus an additional anchor anterior to the biceps. The specimens were placed on a material testing system machine and rotation was measured under a constant torque. The sutures were then removed sequentially from anterior to posterior during testing.
RESULTS: The average ER of the intact shoulder was 115.7° ± 2.6°. After SLAP tear creation and cyclic loading, the ER was 118.5° ± 2.6°, which decreased to 116.5° ± 2.6° after repair. This corresponds to a reduction of 2.0° of ER (P < .0001) with the repair. After release of the anterior anchor, the ER increased to 117.9° ± 2.6°, which corresponds to an increase in shoulder motion of 1.4° of ER (P = .0011). Additional release of the middle anchor, leaving only the posterior anchor intact, resulted in 118.0° ± 2.7° of ER, which corresponds to an increase of only 0.1° of ER (P = .7667).
CONCLUSIONS: Following type 2 SLAP repair in the cadaveric shoulder, removing the effect of the anchor anterior to the biceps resulted in a small but statistically significant increase in ER. The anterior anchor had the greatest effect on ER. The presence of 1 or 2 anchors posterior to the biceps did not have a significant effect on rotation. CLINICAL RELEVANCE: When performing SLAP repairs on those in whom even a small loss of ER would be detrimental, such as baseball pitchers, avoidance of the use of an anchor anterior to the biceps should be considered.
Copyright © 2013 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

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Year:  2012        PMID: 23177591     DOI: 10.1016/j.arthro.2012.06.021

Source DB:  PubMed          Journal:  Arthroscopy        ISSN: 0749-8063            Impact factor:   4.772


  14 in total

1.  National Athletic Trainers' Association Position Statement: Evaluation, Management, and Outcomes of and Return-to- Play Criteria for Overhead Athletes With Superior Labral Anterior-Posterior Injuries.

Authors:  Lori A Michener; Jeffrey S Abrams; Kellie C Huxel Bliven; Sue Falsone; Kevin G Laudner; Edward G McFarland; James E Tibone; Charles A Thigpen; Timothy L Uhl
Journal:  J Athl Train       Date:  2018-03       Impact factor: 2.860

2.  The Double-Pulley Anatomic Technique for Type II SLAP Lesion Repair.

Authors:  Nata Parnes; Mario Ciani; Brian Carr; Paul Carey
Journal:  Arthrosc Tech       Date:  2015-10-12

3.  Clinical outcome of arthroscopic SLAP repair: conventional vertical knot versus knotless horizontal mattress sutures.

Authors:  Hyuk Jae Yang; Kisyck Yoon; Hyonki Jin; Hyun Seok Song
Journal:  Knee Surg Sports Traumatol Arthrosc       Date:  2014-11-27       Impact factor: 4.342

4.  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.

Authors:  Kevin F Dunne; Michael Knesek; Vehniah K Tjong; Brett D Riederman; Charles J Cogan; Hayden P Baker; Cynthia A Kahlenberg; Stephen Gryzlo; Michael A Terry
Journal:  Knee Surg Sports Traumatol Arthrosc       Date:  2020-04-06       Impact factor: 4.342

5.  Reported Technical Aspects of Type II SLAP Lesion Repairs in Athletes.

Authors:  Jack W Weick; Will B Workman; Christopher J Bush; Katherine A McCollum; Hiroyuki Sugaya; Michael T Freehill
Journal:  Arthrosc Sports Med Rehabil       Date:  2021-02-23

Review 6.  Superior Labral Anterior to Posterior Tear Management in Athletes.

Authors:  Cristin John Mathew; David Mark Lintner
Journal:  Open Orthop J       Date:  2018-07-31

7.  Superior Capsular Release After Failed Combined Superior Labral Repair And Biceps Tenodesis For Slap Tear.

Authors:  Yung Han; Janet Lee; Sung Park; Eugene Suh
Journal:  Open Orthop J       Date:  2018-07-31

8.  Is Anatomical Healing Essential for Better Clinical Outcome in Type II SLAP Repair? Clinico-Radiological Outcome after Type II SLAP Repair.

Authors:  Piyush Suresh Nashikkar; Sung-Min Rhee; Chintan Vinod Desai; Joo Han Oh
Journal:  Clin Orthop Surg       Date:  2018-08-22

9.  Arthroscopic Repair of Type II SLAP Lesions in Overhead Athletes.

Authors:  William B Stetson; Samuel Polinsky; Stephanie A Morgan; Jason Strawbridge; Jonathan Carcione
Journal:  Arthrosc Tech       Date:  2019-07-18

Review 10.  Complications and Return to Activity After Arthroscopic Repair of Isolated Type II SLAP Lesions: A Systematic Review Comparing Knotted Versus Knotless Suture Anchors.

Authors:  Derrick M Knapik; Jensen G Kolaczko; Robert J Gillespie; Michael J Salata; James E Voos
Journal:  Orthop J Sports Med       Date:  2020-04-20
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