From the Research
Surgical intervention for a SLAP tear is recommended when conservative treatment fails after 3-6 months, or immediately in cases of complete tears with significant instability, especially in young, active patients or athletes. This recommendation is based on the most recent and highest quality study available, which emphasizes the importance of considering the patient's age, activity level, and functional demands when deciding on surgical intervention 1.
Key Considerations for Surgical Intervention
- Patient's age: younger patients and overhead athletes are more likely to benefit from surgical repair
- Activity level: patients with high functional demands may require surgical intervention to restore optimal shoulder function
- Type of SLAP tear: complete tears with significant instability may require immediate surgical intervention
- Failure of conservative treatment: patients who do not respond to conservative measures such as physical therapy, anti-inflammatory medications, and corticosteroid injections may be candidates for surgical intervention
Conservative Measures
- Physical therapy focusing on rotator cuff strengthening
- Anti-inflammatory medications (such as ibuprofen 400-800mg three times daily or naproxen 500mg twice daily for 1-2 weeks)
- Activity modification
- Possibly corticosteroid injections
Surgical Approach
- Arthroscopic repair using suture anchors to reattach the labrum to the glenoid rim
- Post-operative rehabilitation lasting 4-6 months before full return to activities
- Biceps tenodesis may be considered as an alternative to traditional SLAP repair, especially in patients with biceps tendon-related pain 1
Special Considerations
- Older patients (typically over 40) with degenerative tears may respond better to conservative management or debridement rather than repair
- Throwing athletes may require a more specialized approach to treatment, including rigorous physical therapy centered on hip, core, and scapular exercise 2