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SLAP lesion

Introduction

The long head of the biceps originates from the superior glenoid labrum (fibrocartilaginous rim attached around the margin of the glenoid cavity, figure 1). SLAP is an acronym that stands for "superior labrum from anterior to posterior". Forceful shoulder flexion and rotation may damage the superior labrum thus causing the so called SLAP lesion (figure 2). SLAP lesion is most commonly seen in throwing sports, such as volleyball and handball and in collision sports.

 
Εικόνα 1. Σχηματική παράσταση φυσιολογικού επιχειλίου χόνδρου (labrum) και ρήξης της έκφυσης της μακράς κεφαλής του δικεφάλου (SLAP lesion).
Figure 1. Schematic presentation of glenoid labrum and SLAP lesion.
Figure 1. Schematic presentation of glenoid labrum and SLAP lesion.
 

Clinical presentation - Diagnosis

SLAP lesion presents with shoulder pain that is usually aggravated with overhead activities. A sensible or audible “click” may also exist.

SLAP lesion diagnosis requires high index of suspicious and is confirmed with imaging techniques. MR arthrography is the method of choice for SLAP lesion demonstration.

Treatment

SLAP lesion may be treated conservatively with activity modification and rotator cuff muscles and scapular stabilizers strengthening. Arthroscopic treatment is recommended in athletes that do not respond in conservative treatment. Debridement of the lesion or repair (figure 3 and video 1) is performed, depending on the type of the lesion.

 
Εικόνα 2. Αποκόλληση της έκφυσης της μακράς κεφαλής του δικεφάλου πριν και μετά τη συρραφή.
Figure 2. SLAP lesion.
Figure 2. SLAP lesion.
Εικόνα 2. Αποκόλληση της έκφυσης της μακράς κεφαλής του δικεφάλου πριν και μετά τη συρραφή.
Figure 3. Repair of SLAP lesion.
Figure 3. Repair of SLAP lesion.
 

Video 1. Arthroscopic repair of SLAP lesion.