Classification and Treatment of SLAP Lesion / 대한정형외과학회잡지

ABSTRACT

PURPOSE: The Snyder's classification of SLAP lesion has many limitations in clinical use, His classification has no correlation with the mechanism of jnjury and treatment. Therefore, new rational classification oriented with injury mechanism and its treatment was needed. MATERIALS AND METHODS: This is a retrospective study of 74 patients with SLAP lesion which were found during arthroscopic treatment of 194 patients diagnosed with recurrent shoulder dislocation, impingement syndrome or SLAP lesion between March 1989 and January 1997. Mean follow-up time was 36 months (range, 18 to 72 months) and average age of patients was 26 years old (range, 17-47 yrs). All patients were arthroscopically examined and treated. We classified the SLAP lesion into 3 groups according to the stability of biceps anchor. Group I had superior labral tear (flap tear or bucket-handle tear or degenerative tear) with intact biceps stability, group II had disturbed biceps anchor (unstable shoulder), and group III is a mix of group I and II. By our classification, group I was 32 cases, group II was 31 cases, and group III was 11 cases. We treated the SLAP lesion according to our new classification. Group I was treated with arthroscopic debridement, group II with stabilization of biceps anchor, and group III with arthroscopic debridement and stabilization of biceps anchor. RESULTS: The result by the Rowe rating scale was excellent or good in 29 cases of 32 in group I, 25 cases of 29 in arthroscopic transglenoid suture technique group and 1 case of 2 in the group treated with biodegradable tack (Suretec) in group II, and 10 of 11 cases in group III. There was only one case of postoperative recurrence and no complication was found. Our transglenoid suture technique had a reasonable recurrence rate with few complications. CONCLUSIONS: Thus we propose our new classification and treatment of SLAP lesion, and arthroscopic transglenoid suture technique for the treatment of SLAP type II and III.