Dead Arm Syndrome: Torsional SLAP Lesions versus Internal Impingement

Abstract

Understanding the effect of superior labral lesions on the function of the shoulder is essential to successfully treating the overhead athlete. Recognizing the pseudolaxity due to SLAP lesions and the pathologic “peel-back” sign is critical in evaluating the injured shoulder and repairing the SLAP lesion. The mechanical characteristics of suture anchors are more favorable in resisting the pathologic forces responsible for the peel-back mechanism. The higher success rate of arthroscopic suture anchor repair of SLAP lesions compared with open capsulolabral reconstruction suggests that SLAP lesions are the usual cause of the “dead arm” syndrome. In our experience, arthroscopic repair of SLAP lesions can return the overhead athlete to pre-operative level of function in the vast majority of cases (87% return to pre-operative level for two or more seasons).