SLAP (superior labrum anterior posterior) Lesions

A SLAP tear usually occurs with heavy forceful lifting, repeated overhead activity (tennis, throwing) or a fall on the outstretched hand.

SLAP lesions are classified into 4 types:

Type I
Fraying of the superior labrum is seen. The biceps anchor is intact.
Treatment: Debridement of the frayed edge.

Type II
The superior labrum is detached with detachment of the biceps anchor.
Treatment: Debridement of the superior glenoid rim and reattachment of biceps and labrum.

Type III
a bucket handle type tear of the superior labrum with the biceps anchor intact.
Treatment: Resection of the tear.

Type IV
A bucket handle type tear of the superior labrum with extention into the biceps tendon. Part of the biceps anchor is still intact.
Treatment: Resection of tear and if it is greater than 50% of the tendon involved, tenodesis is recommended.

If remain symptomatic with conservative management, they can be treated surgically.
Type I – arthroscopic debridement id often sufficient
Type II – the labrum is reattached using an anchor, positioned at 12 O’clock.
Type III – the buckle handle tear is excised and the remnant is reattached
Type IV – the tear is resected but biceps tenodesis may be reqired.

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