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J Athl Train. 2000 Jul-Sep; 35(3): 286–292.
PMCID: PMC1323391

Superior Labral Lesions: Diagnosis and Management

Abstract

Objective:

To review the pathoanatomy, classification, and etiologies of lesions of the superior labrum and biceps anchor (SLAP lesions) and to discuss the clinical presentation, with emphasis on physical examination findings and current treatment recommendations.

Data Sources:

We searched MEDLINE for English-language articles published from 1985 to 1999 using the key words “superior labral lesion,” “SLAP lesion,” “labral tear,” and “biceps tendon.” Additional information was obtained from cross- referencing pertinent articles and personal communications with experts in the field of shoulder arthroscopy.

Data Synthesis:

The clinical presentation of superior labral lesions often includes a history of trauma or repetitive overuse in athletes associated with complaints of pain and clicking or popping in the shoulder. The diagnosis can be difficult, as clinical findings may overlap with those of acromioclavicular or rotator cuff problems and exist concomitantly with glenohumeral instability.

Conclusions/Recommendations:

Superior labral lesions are a relatively newly defined cause of shoulder pain and disability. Knowledge about these lesions and a high index of suspicion are essential to identifying this important cause of shoulder pain. Superior labral lesions are usually confirmed and successfully managed arthroscopically.

Full text

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • D'Alessandro DF, Valadie AL. Superior glenoid lesions: a diagnostic and therapeutic challenge. J South Orthop Assoc. 1995 Fall;4(3):214–227. [PubMed]
  • Snyder SJ, Banas MP, Karzel RP. An analysis of 140 injuries to the superior glenoid labrum. J Shoulder Elbow Surg. 1995 Jul-Aug;4(4):243–248. [PubMed]
  • Snyder SJ, Karzel RP, Del Pizzo W, Ferkel RD, Friedman MJ. SLAP lesions of the shoulder. Arthroscopy. 1990;6(4):274–279. [PubMed]
  • Cooper DE, Arnoczky SP, O'Brien SJ, Warren RF, DiCarlo E, Allen AA. Anatomy, histology, and vascularity of the glenoid labrum. An anatomical study. J Bone Joint Surg Am. 1992 Jan;74(1):46–52. [PubMed]
  • Williams MM, Snyder SJ, Buford D., Jr The Buford complex--the "cord-like" middle glenohumeral ligament and absent anterosuperior labrum complex: a normal anatomic capsulolabral variant. Arthroscopy. 1994 Jun;10(3):241–247. [PubMed]
  • Rames RD, Karzel RP. Injuries to the glenoid labrum, including slap lesions. Orthop Clin North Am. 1993 Jan;24(1):45–53. [PubMed]
  • Maffet MW, Gartsman GM, Moseley B. Superior labrum-biceps tendon complex lesions of the shoulder. Am J Sports Med. 1995 Jan-Feb;23(1):93–98. [PubMed]
  • Warner JJ, Kann S, Marks P. Arthroscopic repair of combined Bankart and superior labral detachment anterior and posterior lesions: technique and preliminary results. Arthroscopy. 1994 Aug;10(4):383–391. [PubMed]
  • Andrews JR, Carson WG, Jr, McLeod WD. Glenoid labrum tears related to the long head of the biceps. Am J Sports Med. 1985 Sep-Oct;13(5):337–341. [PubMed]
  • Pagnani MJ, Deng XH, Warren RF, Torzilli PA, Altchek DW. Effect of lesions of the superior portion of the glenoid labrum on glenohumeral translation. J Bone Joint Surg Am. 1995 Jul;77(7):1003–1010. [PubMed]
  • Altchek DW, Warren RF, Wickiewicz TL, Ortiz G. Arthroscopic labral debridement. A three-year follow-up study. Am J Sports Med. 1992 Nov-Dec;20(6):702–706. [PubMed]
  • Cordasco FA, Steinmann S, Flatow EL, Bigliani LU. Arthroscopic treatment of glenoid labral tears. Am J Sports Med. 1993 May-Jun;21(3):425–431. [PubMed]
  • Field LD, Savoie FH., 3rd Arthroscopic suture repair of superior labral detachment lesions of the shoulder. Am J Sports Med. 1993 Nov-Dec;21(6):783–790. [PubMed]
  • Itoi E, Kuechle DK, Newman SR, Morrey BF, An KN. Stabilising function of the biceps in stable and unstable shoulders. J Bone Joint Surg Br. 1993 Jul;75(4):546–550. [PubMed]
  • Pagnani MJ, Speer KP, Altchek DW, Warren RF, Dines DM. Arthroscopic fixation of superior labral lesions using a biodegradable implant: a preliminary report. Arthroscopy. 1995 Apr;11(2):194–198. [PubMed]
  • Rodosky MW, Harner CD, Fu FH. The role of the long head of the biceps muscle and superior glenoid labrum in anterior stability of the shoulder. Am J Sports Med. 1994 Jan-Feb;22(1):121–130. [PubMed]
  • Tomlinson RJ, Jr, Glousman RE. Arthroscopic debridement of glenoid labral tears in athletes. Arthroscopy. 1995 Feb;11(1):42–51. [PubMed]
  • Glousman R, Jobe F, Tibone J, Moynes D, Antonelli D, Perry J. Dynamic electromyographic analysis of the throwing shoulder with glenohumeral instability. J Bone Joint Surg Am. 1988 Feb;70(2):220–226. [PubMed]
  • Jobe FW, Moynes DR, Tibone JE, Perry J. An EMG analysis of the shoulder in pitching. A second report. Am J Sports Med. 1984 May-Jun;12(3):218–220. [PubMed]
  • Glasgow SG, Bruce RA, Yacobucci GN, Torg JS. Arthroscopic resection of glenoid labral tears in the athlete: a report of 29 cases. Arthroscopy. 1992;8(1):48–54. [PubMed]
  • Payne LZ, Jokl P. The results of arthroscopic debridement of glenoid labral tears based on tear location. Arthroscopy. 1993;9(5):560–565. [PubMed]
  • Grauer JD, Paulos LE, Smutz WP. Biceps tendon and superior labral injuries. Arthroscopy. 1992;8(4):488–497. [PubMed]
  • Yoneda M, Hirooka A, Saito S, Yamamoto T, Ochi T, Shino K. Arthroscopic stapling for detached superior glenoid labrum. J Bone Joint Surg Br. 1991 Sep;73(5):746–750. [PubMed]
  • Liu SH, Henry MH, Nuccion S, Shapiro MS, Dorey F. Diagnosis of glenoid labral tears. A comparison between magnetic resonance imaging and clinical examinations. Am J Sports Med. 1996 Mar-Apr;24(2):149–154. [PubMed]
  • Kibler WB. Specificity and sensitivity of the anterior slide test in throwing athletes with superior glenoid labral tears. Arthroscopy. 1995 Jun;11(3):296–300. [PubMed]
  • Jobe FW, Kvitne RS, Giangarra CE. Shoulder pain in the overhand or throwing athlete. The relationship of anterior instability and rotator cuff impingement. Orthop Rev. 1989 Sep;18(9):963–975. [PubMed]
  • Flannigan B, Kursunoglu-Brahme S, Snyder S, Karzel R, Del Pizzo W, Resnick D. MR arthrography of the shoulder: comparison with conventional MR imaging. AJR Am J Roentgenol. 1990 Oct;155(4):829–832. [PubMed]
  • Legan JM, Burkhard TK, Goff WB, 2nd, Balsara ZN, Martinez AJ, Burks DD, Kallman DA, O'Brien TJ, Lapoint JM. Tears of the glenoid labrum: MR imaging of 88 arthroscopically confirmed cases. Radiology. 1991 Apr;179(1):241–246. [PubMed]
  • Hodler J, Kursunoglu-Brahme S, Flannigan B, Snyder SJ, Karzel RP, Resnick D. Injuries of the superior portion of the glenoid labrum involving the insertion of the biceps tendon: MR imaging findings in nine cases. AJR Am J Roentgenol. 1992 Sep;159(3):565–568. [PubMed]
  • Hunter JC, Blatz DJ, Escobedo EM. SLAP lesions of the glenoid labrum: CT arthrographic and arthroscopic correlation. Radiology. 1992 Aug;184(2):513–518. [PubMed]
  • Cartland JP, Crues JV, 3rd, Stauffer A, Nottage W, Ryu RK. MR imaging in the evaluation of SLAP injuries of the shoulder: findings in 10 patients. AJR Am J Roentgenol. 1992 Oct;159(4):787–792. [PubMed]
  • Smith AM, McCauley TR, Jokl P. SLAP lesions of the glenoid labrum diagnosed with MR imaging. Skeletal Radiol. 1993 Oct;22(7):507–510. [PubMed]
  • Monu JU, Pope TL, Jr, Chabon SJ, Vanarthos WJ. MR diagnosis of superior labral anterior posterior (SLAP) injuries of the glenoid labrum: value of routine imaging without intraarticular injection of contrast material. AJR Am J Roentgenol. 1994 Dec;163(6):1425–1429. [PubMed]
  • Chandnani VP, Yeager TD, DeBerardino T, Christensen K, Gagliardi JA, Heitz DR, Baird DE, Hansen MF. Glenoid labral tears: prospective evaluation with MRI imaging, MR arthrography, and CT arthrography. AJR Am J Roentgenol. 1993 Dec;161(6):1229–1235. [PubMed]
  • Gusmer PB, Potter HG, Schatz JA, Wickiewicz TL, Altchek DW, O'Brien SJ, Warren RF. Labral injuries: accuracy of detection with unenhanced MR imaging of the shoulder. Radiology. 1996 Aug;200(2):519–524. [PubMed]
  • Chandnani VP, Gagliardi JA, Murnane TG, Bradley YC, DeBerardino TA, Spaeth J, Hansen MF. Glenohumeral ligaments and shoulder capsular mechanism: evaluation with MR arthrography. Radiology. 1995 Jul;196(1):27–32. [PubMed]
  • Burkhart SS, Fox DL. Case report: arthroscopic repair of a type IV SLAP lesion--the red-on-white lesion as a component of anterior instability. Arthroscopy. 1993;9(5):488–497. [PubMed]
  • Speer KP, Warren RF. Arthroscopic shoulder stabilization. A role for biodegradable materials. Clin Orthop Relat Res. 1993 Jun;(291):67–74. [PubMed]

Articles from Journal of Athletic Training are provided here courtesy of National Athletic Trainers Association