Effectiveness of biceps tenodesis versus SLAP repair for surgical treatment of isolated SLAP lesions: A systemic review and meta-analysis

Min Li; Atik Badshah Shaikh; Jinbo Sun; Peng Shang; Xiliang Shang

doi:10.1016/j.jot.2018.09.002

Effectiveness of biceps tenodesis versus SLAP repair for surgical treatment of isolated SLAP lesions: A systemic review and meta-analysis

J Orthop Translat. 2018 Oct 4:16:23-32. doi: 10.1016/j.jot.2018.09.002. eCollection 2019 Jan.

Authors

Min Li¹, Atik Badshah Shaikh^{2

3}, Jinbo Sun⁴, Peng Shang^{2

3}, Xiliang Shang⁵

Affiliations

¹ Department of Orthopaedic Surgery, Shenzhen Hospital, Southern Medical University, Shenzhen, China.
² Research & development institute in Shenzhen, Research & Development Institute in Shenzhen, Northwestern Polytechnical University, Shenzhen, Guangdong, China.
³ Institute of Special Environmental Biophysics, Key Laboratory for Space Bioscience and Biotechnology, Institute of Special Environmental Biophysics, School of Life Sciences, Northwestern Polytechnical University, Xi'an, Shanxi, China.
⁴ Department of Sports Medicine, Xingyi People's Hospital, Guizhou Medical University, Guizhou, China.
⁵ Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China.

Abstract

Background: Type II superior labrum anterior and posterior (SLAP) lesions could induce chronic shoulder pain and impaired movement. Current management of Type II SLAP lesions consists of two well-established surgical procedures: arthroscopic biceps tenodesis and SLAP repair. However, which technique is preferred over the other is still a controversy.

Methods: We performed a systematic electronic database search on Cochrane Central Register of Controlled Trials, MEDLINE and Embase to identify articles equating superior labral repair with biceps tenodesis, which were reported before August 2017 which included the phrase "superior labral anterior posterior" or "SLAP." The randomised controlled clinical trials that met our criteria were evaluated for quality of methodology. The results obtained were further analysed and correlated to present the benefits and drawbacks comparing the two SLAP repair surgical procedures.

Result: Based on our inclusion and exclusion criteria, we identified five articles (204 patients) that were included in this meta-analysis. The results indicate that prevalence of patients return to preinjury sports level and the patients satisfaction were found to be significantly better in tenodesis group than in the SLAP repair group (p < 0.05). As for the patient age, VAS score, American Shoulder and Elbow Surgeons score, University of California at Los Angeles score, postoperative stiffness and reoperation rates, no significant differences were evident among the two groups, thus supporting the results reported in the current literatures (p > 0.05).

Conclusions: Both the surgical treatments, SLAP repair and the biceps tenodesis, are efficacious in pain alleviation and recovery of shoulder function. But, compared with SLAP repair, biceps tenodesis showed higher rate of patient satisfaction and return to preinjury sports participation.

The translational potential of this article: Impart better understanding regarding discrepancies in the outcomes between biceps tenodesis and SLAP repair in treating patients with isolated Type II SLAP lesions.

Keywords: ASES, American Shoulder and Elbow Surgeons score; CMS, Coleman methodology score; LOE, Level of evidence; Labral repair; SLAP, superior labrum anterior and posterior; Superior labrum anterior and posterior; Tenodesis; UCLA, University of California at Los Angeles score; VAS, Visual Analogue Scale score.