Type VIII SLAP Repair at Midterm Follow-Up: Throwers Have Greater Pain, Decreased Function, and Poorer Return to Play

Mitchell S Fourman; Justin W Arner; Steve Bayer; Dharmesh Vyas; James P Bradley

doi:10.1016/j.arthro.2018.06.055

Type VIII SLAP Repair at Midterm Follow-Up: Throwers Have Greater Pain, Decreased Function, and Poorer Return to Play

Arthroscopy. 2018 Dec;34(12):3159-3164. doi: 10.1016/j.arthro.2018.06.055. Epub 2018 Oct 6.

Authors

Mitchell S Fourman¹, Justin W Arner¹, Steve Bayer¹, Dharmesh Vyas¹, James P Bradley²

Affiliations

¹ Division of Sports Medicine, Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, U.S.A.; Burke and Bradley Orthopedics, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, U.S.A.; School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A.
² Division of Sports Medicine, Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, U.S.A.; Burke and Bradley Orthopedics, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, U.S.A.; School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A.. Electronic address: bradleyjp@upmc.edu.

PMID: 30301630
DOI: 10.1016/j.arthro.2018.06.055

Abstract

Purpose: To evaluate and compare midterm outcomes and return to play (RTP) of throwers and nonthrowers who underwent type VIII SLAP repair.

Methods: With 4-year minimum follow-up, stability, pain, range of motion (ROM), Kerlan-Jobe Orthopaedic Clinic (KJOC), and American Shoulder and Elbow Surgeons (ASES) scores; surgical satisfaction; and RTP were compared between throwing and nonthrowing athletes who underwent repair of type VIII SLAP lesions between 2003 and 2014.

Results: 46 patients (27 throwers and 19 nonthrowers) were included. The athletes were aged 24.2 ± 9.2 years at the time of surgery. The mean follow-up period was 6.6 ± 2.0 years. A significant improvement in stability, pain, ROM, KJOC, and ASES scores was seen after surgery in both throwers and nonthrowers (P < .05). When postoperative outcomes were compared, throwers had more pain (P = .047), decreased ROM (P = .03), lower KJOC scores (52.2 ± 24.0 in throwers vs 87.5 ± 18.8 in nonthrowers, P < .0001), and lower ASES scores (43.5 ± 7.1 in throwers vs 48.3 ± 3.0 nonthrowers, P = .02). There was no difference in stability (P = .06), surgical satisfaction (96.3% in throwers vs 100% in nonthrowers, P > .99), or overall RTP (70.4% in throwers vs 94.7% in nonthrowers, P = .06). However, throwers were less likely to RTP at their preoperative level (37.0% in throwers vs 73.7% in nonthrowers, P = .02).

Conclusions: Surgical repair of type VIII SLAP tears led to significant improvements in stability, pain, ROM, and outcome scores at midterm follow-up. Compared with nonthrowers, throwers had significantly more pain, less ROM, and worse function. Throwers were also less likely to RTP at their preoperative level. These findings suggest that type VIII SLAP tears should be repaired in all athletes because outcomes do improve, although throwers require specific counseling and expectation management regarding their ability to RTP at their preinjury level.

Level of evidence: Level III, therapeutic case-control study.

MeSH terms

Adolescent
Adult
Athletic Injuries / physiopathology
Athletic Injuries / surgery*
Case-Control Studies
Female
Follow-Up Studies
Humans
Joint Instability / physiopathology
Joint Instability / surgery
Male
Middle Aged
Pain Measurement*
Range of Motion, Articular / physiology*
Retrospective Studies
Return to Sport*
Shoulder Injuries / physiopathology
Shoulder Injuries / surgery*
Suture Anchors
Young Adult