SLAP Repair Surgeon in San Juan Capistrano, Fountain Valley CA
Repeated use of the shoulder while throwing or a fall onto the shoulder can result in a SLAP (superior labrum anterior and posterior) tear or injury. Dr. Sohn provides diagnosis and individualized nonoperative and operative treatments for the shoulder including SLAP repair in San Juan Capistrano, Fountain Valley CA. Dr. Sohn also provides the highest level of care during and after surgery. Contact Dr. Sohn’s office for an appointment today!
What is a SLAP Repair?
By Roger C. Sohn, MD
A SLAP repair is an arthroscopic shoulder procedure to treat a specific type of injury to the labrum called a SLAP tear.
Shoulder Anatomy
Your shoulder joint is a ball and socket joint made up of the humerus and the shallow socket of the shoulder blade called the glenoid. The outer edge of the glenoid is surrounded by a strong fibrous tissue called the labrum. Several structures, including the bicep tendon anchor onto the labrum.
What is a SLAP Tear?
SLAP stands for superior labrum anterior to posterior. It is an injury to the upper labrum. This injury may also involve the biceps tendon, which is attached to the top part of the labrum. The injury occurs from repeated use of the shoulder while throwing or other shoulder injury. It is theorized that the upper labrum and bicep anchor “peel back” from their bony attachment when the shoulder rotates upward and backward.
What are the Symptoms of a SLAP Tear?
SLAP tears tend to cause a chronic pain in the shoulder that does not get better with time. Typical complaints are pain in the front of the shoulder or deep inside the shoulder. Patients occasionally experience a clicking sensation, especially when rotating the shoulder externally and upward. This position is commonly called the “cocking position” when a thrower winds up before ball release. This painful position is common in other sporting activities including swimming, tennis, volleyball, and weight lifting.
What are the Indications for a SLAP repair?
A SLAP repair is indicated to treat the torn labrum of the shoulder socket when conservative treatment measures such as NSAIDs (non-steroidal anti-inflammatory medications) and physical therapy do not relieve the symptoms of a SLAP tear.
How is a SLAP Repair performed?
A SLAP repair is a minimally invasive surgery that uses an arthroscope, a fiber optic camera that is placed inside the shoulder. By using the camera and several small ports, a full repair can be performed without making large incisions. The procedure is performed under general anesthesia and a nerve block.
Once inside the joint, I can identify the type of SLAP tear and begin to repair it. In general, labral repairs are performed on type 2 SLAP tears. Other types are not likely to heal and SLAP repair is not indicated in those types.
While viewing the inside of the joint, a suture strap can be passed around the torn labrum. This is then anchored into a small bone socket we make with a drill.
Additional anchors can be placed as required for securing the torn labrum to the bone of the shoulder socket. I generally use a “knotless technique” to protect the joint cartilage.
What is the Postoperative Care following SLAP Repair?
After the procedure, your arm will be placed in a sling for several weeks to protect the repair. Right after the surgery, patients require some pain medication but they can often stop taking it after a week or two. You should avoid driving for a few weeks after the surgery.
A very specific physical therapy protocol is followed after surgery. The main focus at first is to gently regain range of motion while protecting the repair. It takes about 12 weeks for the labrum to fully adhere to the bone. However, there is enough strength to the repair at the 8 week mark to allow more progressive stretching. We allow people to start the full strengthening and return to sports regimen after 3 months. Most contact athletes can return to sports between 4 and 6 months after the surgery.
What are the Associated Risks and Complications of SLAP Repair?
As with any surgical procedure, SLAP repair may involve certain potential risks and complications including:
- Infection
- Shoulder stiffness
- Injury to nerves or blood vessels
- Failure to fully heal the injury.
What are Dr. Sohn’s Results After Shoulder Surgery:
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