What is a superior labrum anterior to posterior lesion (SLAP) lesions?
SLAP lesions involve an injury to the superior glenoid labrum and the biceps anchor complex. The glenoid labrum is a cartilaginous lining of the glenoid, which serves to deepen the glenoid resulting in increased stability of the shoulder. Injuries to the labrum that result in fraying or tears are often seen in overhead throwing athletes. Symptoms may include a deep shoulder aching and painful popping or catching in the shoulder with overhead activities. Provocative tests including the O’Brien active compression test, the crank test, and the clunk test all have poor sensitivity and specificity. They are designed to elicit pain when the lesion is compressed. Magnetic resonance imaging (MRI) with or without arthrography is the gold standard for diagnosis, with a sensitivity/specificity of over 90% in detecting SLAP lesions. Nonsurgical care includes NSAIDs, physical therapy, and 6 weeks of rest followed by gradual return to activity. If nonsurgical therapy fails, surgical arthroscopy for diagnosis and repair is done.
