Study: Three times more shoulder cases reported as SLAP repairs

Weber SC. Am J Sports Med.2012; 214(1):267-271. doi: 10.1177/0363546512447785

  • August 2, 2012

The percentage of shoulder cases reported as SLAP lesion repairs by American Board of Orthopedic Surgery part 2 candidates is three times greater than published evidence reinforced by current literature, according to this study.

Researchers searched the American Board of Orthopedic Surgery part 2 database for all SLAP lesions and SLAP repairs performed between 2003 to 2008. They evaluated changes in treatment and identified outcomes and related complications of arthroscopic repair of SLAP lesions. The study population was 78.4% males with a mean age of 36.4 ± 12 years and 21.6% females with a mean age of 40.9 ± 14 years.

Researchers observed 4,975 SLAP repairs, which was 9.4% of all the applicants’ shoulder cases. The percentage of shoulder SLAP repairs increased from 9.4% in 2003 to 10.1% in 2008. During follow-up at 8.9 weeks, 26.3% of patients said the pain was absent and 13.1% reported normal functioning. Overall, 40.1% of applicants self-reported their patients as having outstanding results with a complication rate of 4.4%. There was a higher percentage of SLAP repairs for sports medicine specialists (12.4%) vs. general orthopedic surgeons (9.2%).

“Focusing on educating young orthopedic surgeons to appropriately recognize and treat symptomatic SLAP lesions may bring the rate of SLAP repairs down,” the researchers concluded in the abstract.

Perspective
Matthew T. Provencher, MD

CDR Matthew Provencher

  • The study by Weber and colleagues is a 5-year review of the ABOS Part II boards’ database regarding the incidence, complications and outcomes of SLAP II repairs. Although this data is purely database driven and subject to certain biases inherent to record mining, there are some very important findings of the study.

    Although the increase of shoulder SLAP repairs statistically increased during the study period, the amount was modest (0.7%). One of the concerning findings is that the patients who had a SLAP repair were up to age 85 years in males and 88 years in females. The current body of literature would not support SLAP repairs in the middle-aged and elderly population, although the precise age limit has yet to be defined. In addition, the physician-reported outcomes demonstrated that 75% of patients still had postoperative pain, and function was normal in only 13%, meaning that the patients are experiencing notable postoperative limitations. However, these numbers may be somewhat difficult to interpret as there may be other confounders such as associated procedures and shoulder conditions that are independently decreasing shoulder function.

    In summary, although a database study, this manuscript provides us with important information about the incidence and demographics of SLAP repairs in those that have recently taken their oral boards, and emphasizes the importance of proper patient selection and knowledge of the pathophysiology of a SLAP tear for optimal patient outcomes.

    • CDR Matthew Provencher, MD, MC, USN
    • U.S. Naval Medical Center
      San Diego
      ORTHOPEDICS TODAY Editorial Board member
  • Disclosures: Provencher has no relevant financial disclosures.

Comments

Healio is intended for health care provider use and all comments will be posted at the discretion of the editors. We reserve the right not to post any comments with unsolicited information about medical devices or other products. At no time will Healio be used for medical advice to patients.