In general, favorable outcomes have been achieved with arthroscopic repair of superior labral anterior-posterior (SLAP) tears. However, some patients remain dissatisfied or suffer further injury after SLAP repair and may seek additional treatment to alleviate their symptoms. The cause of persistent pain or recurrent symptoms after repair is likely multifactorial; therefore, careful preoperative workup is required to elucidate the cause of pain. Review of the details of previous surgical procedures is crucial because certain fixation methods are prone to failure or can cause additional injury. Failed SLAP repair can be managed with nonsurgical or surgical options. Nonsurgical modalities include physical therapy and strengthening programs, anti-inflammatory agents, and activity modification. Surgical options include revision SLAP repair and biceps tenotomy or tenodesis with or without revision SLAP repair. Outcomes after surgical management of failed SLAP repair are inferior to those of primary repair. Select patients may be better served by primary biceps tenodesis rather than SLAP repair.
From the Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA.
Dr. Brockmeier or an immediate family member serves as a paid consultant to MicroAire Surgical Instruments and has received research or institutional support from Arthrex and Tornier. Dr. Miller or an immediate family member serves as a board member, owner, officer, or committee member of the American Orthopaedic Society for Sports Medicine and Miller Orthopaedic Review Enterprises. Neither Dr. Werner nor any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article.