SLAP TEARS OF THE GLENOID LABRUM IN CONTACT ATHLETES

Abstract

Aims To describe the distribution, clinical presentation of SLAP tears in rugby players, and time taken for return to sport.

Method A retrospective review of 51 shoulder arthroscopies performed on professional rugby players over a 35 month period was carried out. All patients diagnosed with a SLAP lesion at arthroscopy were identified. Each patient’s records were reviewed to record age, injury side, mechanism of injury, clinical diagnosis, investigations and results, management, and return to play.

Results The incidence of SLAP tears was 35%. All 18 patients were male with an average age of 27yrs. There were 11 isolated SLAP tears (61%), 3 SLAP tears associated with a Bankart lesion (17%), 2 SLAP tears associated with a posterior labral lesion (11%) and 2 SLAP tears associated with an anterior and posterior labral injury (11%). Of the 18 SLAP tears, 14 (78%) were Type 2, 3(17%) were Type 3 and 1(5%) was Type 4. All patients recalled a specific heavy tackle with fall onto the lateral aspect of shoulder. No patient sustained a complete dislocation. None of the patients presented with symptoms of instability. MR Arthrograms were performed in 17 of the 18 patients. SLAP tears were detected in 13 patients (76%). All patients underwent arthroscopic reconstruction within 6 months post injury. At Arthroscopy 7 patients (39%) were found to have associated injuries. Preoperatively 11% of patients were satisfied with their shoulder. By 6 months post surgery 89% of patients were satisfied and 95% were back to their previous activity level. Patients with isolated SLAP tears returned to sports at an average of 2.6 months post surgery.

Conclusion SLAP tears are a common injury in rugby players with shoulder pain following injury. These can often be diagnosed with MR arthrography. Arthroscopic repair is associated with excellent results and early return to sports.