SLAP tear

A SLAP tear or SLAP lesion is an injury to the glenoid labrum (fibrocartilaginous rim attached around the margin of the glenoid cavity). SLAP is an acronym for 'superior labral tear from anterior to posterior'. A SLAP tear or SLAP lesion is an injury to the glenoid labrum (fibrocartilaginous rim attached around the margin of the glenoid cavity). SLAP is an acronym for 'superior labral tear from anterior to posterior'. Several symptoms are common but not specific: The shoulder joint is a 'ball-and-socket' joint. However, the 'socket' (the glenoid fossa of the scapula) is small, covering at most only a third of the 'ball' (the head of the humerus). It is deepened by a circumferential rim of fibrocartilage, the glenoidal labrum. Previously there was debate as to whether the labrum was fibrocartilaginous as opposed to hyaline cartilage found in the remainder of the glenoid fossa. Previously, it was considered a redundant, evolutionary remnant, but is now considered integral to shoulder stability. Most agree that the proximal tendon of the long head of the biceps brachii muscle becomes fibrocartilaginous prior to attaching to the superior aspect of the glenoid. The long head of the triceps brachii inserts inferiorly, similarly. Together, all of those cartilaginous extensions are termed the 'glenoid labrum'. A SLAP tear or lesion occurs when there is damage to the superior (uppermost) area of the labrum.These lesions have come into public awareness because of their frequency in athletes involved in overhead and throwing activities in turn relating to relatively recent description of labral injuries in throwing athletes, and initial definitions of the 4 (major) SLAP sub-types, all happening since the 1990s. The identification and treatment of these injuries continues to evolve. Twelve varieties of SLAP lesion have been described, with initial diagnosis by MRI or arthrography and confirmation by direct arthroscopy. There is evidence in literature to support both surgical and non-surgical forms of treatment. In some, physical therapy can strengthen the supporting muscles in the shoulder joint to the point of reestablishing stability. Surgical treatment of SLAP tears has become more common in recent years. The success rate for repairing isolated SLAP tears is reported between 74-94%. While surgery can be performed as a traditional open procedure, an arthroscopic technique is currently favored being less intrusive with low chance of iatrogenic infection.