Does a SLAP Tear Require Surgery?
Typically, non-surgical treatments are the initial course of action with a SLAP tear. In older patients, nonsurgical methods usually relieve symptoms. These remedies include the use of an anti-inflammatory medications like ibuprofen to ease the initial pain. A prescribed program of physical therapy may also be recommended. The goals of therapy will be to strengthen the muscles stabilizing the shoulder.
If the condition does not improve or worsens despite good nonsurgical management, surgical repair is considered. In young patients (ie. less than 30), SLAP tears are repaired arthroscopically. This is done by abrading the bony attachment site to get healing cells out of the bone and then using small bone anchors to sew the labral tissue back into place so it can heal. In older patients (ie. over 40), there is often poor healing potential of the labral tissue as the tissue is degenerative (has seen lots of wear and tear). Thus, in older patients, torn flaps of labral tissue are cleaned up arthroscopically and if there is associated tearing of the biceps tendon attachment on the top of the glenoid, then a biceps tenodesis is performed.
A biceps tenodesis is done arthroscopically or open depending on a number of factors. In a biceps tenodesis, the diseased and torn portion of the upper biceps tendon is removed and then in the area where the biceps tendon becomes normal, the tendon is secured to the humerus bone. In this way, the biceps tendon is attached further down the arm where the tendon is normal. The diseased, torn, portion of the tendon that is causing pain is removed from the shoulder.