Return to Sport After the Surgical Treatment of Superior Labrum Anterior to Posterior Tears

Systematic review comparing return to sport rates after arthroscopic SLAP repair versus biceps tenodesis:


– Superior labral anterior-posterior (SLAP) tears are common injuries in athletes
– Controversy exists regarding optimal surgical treatment for SLAP tears
– Objective was to compare return to sport (RTS) rates after SLAP repair versus biceps tenodesis


– Systematic review performed per PRISMA guidelines
– Searched PubMed, Embase, Cochrane databases
– Inclusion criteria were studies evaluating RTS after SLAP repair, SLAP repair with cuff debridement, or biceps tenodesis
– 15 studies with 501 patients met inclusion criteria
– Outcomes extracted included RTS rates


– 195 patients underwent isolated SLAP repair (mean age 31yrs)
– RTS rate 79.5%
– Return to pre-injury level 63.6%

– 222 patients underwent SLAP repair with cuff debridement (mean age 22yrs)
– RTS rate 76.6%
– Return to pre-injury level 66.7%

– 84 patients underwent biceps tenodesis (mean age 42yrs)
– RTS rate 84.5%
– Return to pre-injury level 78.6%

– Biceps tenodesis had highest overall RTS and return to pre-injury level


– All 3 procedures had high overall RTS rates
– Biceps tenodesis had higher RTS and return to pre-injury level compared to SLAP repair techniques
– Older patient age in biceps tenodesis group may have contributed to higher RTS rates
– Biceps tenodesis may be preferable for older athletes with SLAP tears
– More studies needed controlling for age, activity level, overhead sport participation


– Arthroscopic SLAP repair and biceps tenodesis have high RTS rates
– Biceps tenodesis demonstrated higher RTS rates compared to SLAP repair
– Age differences between groups limit ability to directly compare outcomes
– Further research needed on optimal management of SLAP tears in young overhead athletes
– Shared decision making is important when selecting SLAP surgery technique

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