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This Article Full Text Full Text (PDF) All Versions of this Article: 36/2/247    most recent 0363546507308194v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Request Reprints Citing Articles Citing Articles via ISI Web of Science (2) Citing Articles via Google Scholar Google Scholar Articles by Franceschi, F. Articles by Denaro, V. Search for Related Content PubMed PubMed Citation Articles by Franceschi, F. Articles by Denaro, V. Related Collections Shoulder Arthroscopy Operative

No Advantages in Repairing a Type II Superior Labrum Anterior and Posterior (SLAP) Lesion When Associated With Rotator Cuff Repair in Patients Over Age 50

A Randomized Controlled Trial

Francesco Franceschi, MD^*, Umile Giuseppe Longo, MD^*, Laura Ruzzini, MD^*, Giacomo Rizzello, MD^*, Nicola Maffulli, MD, PhD, FRCS (Orth)^, and Vincenzo Denaro, MD^*

From the ^* Department of Orthopaedic and Trauma Surgery, Campus Biomedico University, Rome, Italy, and the Department of Trauma and Orthopaedic Surgery, University Hospital of North Staffordshire, Keele University School of Medicine, Stoke on Trent, United Kingdom

Address correspondence to Nicola Maffulli, Thornburrow Drive, Hartshill, Stoke on Trent, United Kingdom ST4 7QB (e-mail: osa14{at}keele.ac.uk).

Background: Arthroscopic management has been recommended for some superior labrum anterior and posterior (SLAP) lesions, but no studies have focused on patients over 50 years of age with rotator cuff tear and a type II SLAP lesion.

Hypothesis: In patients over 50 years of age with an arthroscopically confirmed lesion of the rotator cuff and a type II SLAP lesion, there is no difference between (1) repair of both lesions and (2) repair of the rotator cuff tear without repair of the SLAP II lesion but with a tenotomy of the long head of the biceps.

Study Design: Randomized controlled clinical trial; Level of evidence, 1.

Methods: We recruited 63 patients. In 31 patients, we repaired the rotator cuff and the type II SLAP lesion (group 1). In the other 32 patients, we repaired the rotator cuff and tenotomized the long head of the biceps (group 2). Seven patients (2 in group 1 and 5 in group 2) were lost to final follow-up.

Results: At a minimum 2.9 years’ follow-up, statistically significant differences were seen with respect to the University of California, Los Angeles (UCLA) score and range of motion values. In group 1 (SLAP repair and rotator cuff repair), the UCLA showed a statistically significant improvement from a preoperative average rating of 10.4 (range, 6–14) to an average of 27.9 (range, 24–35) postoperatively (P < .001). In group 2 (biceps tenotomy and rotator cuff repair), the UCLA showed a statistically significant improvement from a preoperative average rating of 10.1 (range, 5–14) to an average of 32.1 (range, 30–35) postoperatively (P <.001) There was a statistically significant difference in total postoperative UCLA scores and range of motion when comparing the 2 groups postoperatively (P < .05).

Conclusions: There are no advantages in repairing a type II SLAP lesion when associated with a rotator cuff tear in patients over 50 years of age. The association of rotator cuff repair and biceps tenotomy provides better clinical outcome compared with repair of the type II SLAP lesion and the rotator cuff.

Key Words: rotator cuff • tenotomy • biceps tendon • shoulder • arthroscopy • SLAP lesion