Surgical Management of Superior Labral Tears in Athletes: Focus on Biceps Tenodesis

Garrett V Christensen, Karch M Smith, Jun Kawakami, Peter N Chalmers Department of Orthopaedic Surgery, University of Utah Health, Salt Lake City, UT, USACorrespondence: Peter N ChalmersDepartment of Orthopaedic Surgery, 590 Wakara Way, Salt Lake City, UT, 84105 Tel +1 503 803 0643Fax +1 314 747 2599Email Peter.Chalmers@hsc.utah.eduAbstract: Superior labrum anterior-posterior (SLAP) lesions are common in overhead athletes. Though some patients have asymptomatic lesions, many tears cause pain and diminished athletic performance. Accurate diagnosis of SLAP lesions can be challenging as the sensitivity and specificity of both the physical exam and advanced imaging is questionable. Management is also difficult, as treatment can be life-altering or career-ending for many athletes. If first-line nonoperative treatment fails, surgical options may be considered. The optimal surgical management of SLAP lesions in athletes is debated. Historically, return to play (RTP) rates among athletes who have undergone arthroscopic SLAP repair have been unsatisfactory, prompting clinicians to seek alternate surgical options. Biceps tenodesis (BT) has been postulated to eliminate biceps tendon-related pain in the shoulder and is increasingly used as a primary procedure for SLAP lesions. The purpose of this text is to review the current literature on the surgical management of SLAP lesions in athletes with an emphasis on the role of BT.Keywords: SLAP tear, SLAP lesion, superior labrum anterior-posterior, biceps-labral complex, throwing athlete, overhead athlete