A SLAP tear is an injury to the labrum of the shoulder, which is the ring of cartilage that surrounds the socket of the shoulder joint. The term SLAP stands for Superior Labrum Anterior and Posterior. In a SLAP injury, the top (superior) part of the labrum is injured. This top area is also where the biceps tendon attaches to the labrum. A SLAP tear occurs both in front (anterior) and back (posterior) of this attachment point. The biceps tendon is involved in the injury. SLAP repair is an arthroscopic procedure that is performed to repair a tear of the biceps tendon at the point where it connects to the labrum.
The head of the upper arm bone fits into a rounded socket in the shoulder blade. This socket is called the glenoid. Surrounding the outside edge of the glenoid is a rim of strong, fibrous tissue called the labrum. The labrum helps to deepen the socket and stabilize the shoulder joint. It also serves as an attachment point for many of the ligaments of the shoulder, as well as one of the tendons from the biceps muscle in the arm.
The surgery is done as an outpatient procedure, allowing patients to go home the same day. This surgical procedure involves repairing and reattaching the tendon using absorbable tacks, wires or sutures. Initially, a few small incisions will be made in the shoulder. An arthroscopic camera is inserted through one of the incisions. The others will be used as access points for other arthroscopic tools. After any loose bits of tissue are removed, the surgeon drills a small hole into the glenoid bone where the labrum has torn away. A tiny anchor tied to a suture is implanted in the glenoid bone. Some tears may be repaired with just one anchor; others require multiple anchors. After this, the surgeon ties the sutures around the torn labrum, reattaching it firmly to the glenoid. If the tendon cannot be repaired, it is released.
If the injury is confined to the labrum itself, without involving the tendon, the biceps tendon attachment is still stable. The surgeon will remove the torn flap and correct any other associated problems.
After surgery, the patient is required to keep the shoulder in a sling for three to four weeks. Physical therapy with gentle, passive range-of-motion exercises will be required to strengthen the joint. Most patients can regain normal activities within three to six months.