ObjectiveTo evaluate the effectiveness of arthroscopic treatment of superior labrum anterior and posterior (SLAP) injury by absorbable anchors through anterior and posterior approach. MethodsBetween January 2010 and August 2012, 28 patients with Snyder II type of SLAP injury underwent arthroscopic operation by absorbable anchors through anterior and posterior approach. There were 15 males and 13 females, aged from 30 to 45 years (mean, 36.5 years). The left shoulder was involved in 12 cases and the right shoulder in 16 cases. All patients had a clear history of trauma. The disease duration ranged from 2 weeks to 3 years (median, 13 months). The results of O'Brien test and Speed test were positive in 25 cases and 26 cases respectively. Shoulder pain visual analogue scale (VAS) was 7.6±1.4. The Constant score of shoulder joint function was 60.2±4.3. ResultsOperation was successfully completed, and the incision healed well in all cases, with no complication. The follow-up time ranged from 12 to 36 months (mean, 24.5 months). The symptoms of shoulder joint interlocking, snapping, and instability disappeared. The joint pain was significantly improved. At 12 months after surgery, Constant score of shoulder joint function was 92.7±4.5, showing significant difference when compared with preoperative score (t=-30.279, P=0.000); the shoulder pain VAS score was 1.1±0.9, showing significant difference when compared with preoperative score (t=23.810, P=0.000). At 1 year after operation, MRI examination showed complete healing in 25 cases, and high signal in 3 cases, but the pain and activity were significantly improved. ConclusionArthroscopic treatment of SLAP injury by absorbable anchors through anterior and posterior approach has the advantages of less injury, small incision, and quick recovery, so it is an ideal operation method.
ObjectiveTo evaluate the clinical therapeutic effect of biceps tendon tenotomy and fixation versus biceps tendon repair for shoulder superior labrum anterior posterior (SLAP) lesions with Meta-analysis. MethodsThe databases such as PubMed, EMbase, the Cochrane Library (Issue 3, 2014), CBM, VIP and CJFD (from the establishment time of databases to December 2014) were searched to collect all randomized controlled trials (RCT) on the clinical effectiveness of biceps tendon tenotomy and fixation versus biceps tendon repair for shoulder SLAP lesions. Two reviewers independently screened the literature according to the inclusive and exclusive criteria, extracted the data, and assessed the methodological quality of included studies. After the data extraction and methodological quality evaluation, meta-analysis was conducted with RevMan 5.0 software. ResultsThree RCT were included. Among the total 137 patients involved, Meta-analysis showed that, compared with the biceps tendon repair group, the biceps tenotomy group had superior amount in the UCLA score [WMD=3.43, 95%CI (2.29, 4.56), P<0.000 01], the shoulder pain [WMD=1.18, 95%CI (0.30, 2.05), P=0.009], function [WMD=0.96, 95%CI (0.51, 1.41), P<0.000 1] and satisfaction [WMD=1.16, 95%CI (0.31, 2.01), P=0.007] with significant differences. But there were no significant differences between the two groups in the shoulder flextion [WMD=0.10, 95%CI (-0.87, 1.06), P=0.84] and strength [WMD=0.13, 95%CI (-0.09, 0.35), P=0.25]. ConclusionBased on the current studies, the biceps tenotomy and fixation is superior to the biceps tendon repair in treating shoulder SLAP lesions. For the quality restrictions and possible publication bias of the included studies, more double blind, high quality RCT are required to further evaluate the effects.