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angieliu
31-05-2007, 09:00 PM
Hi

Does anyone have any info on the accuracy in determining SLAP tears? I know that MRIs don't always show SLAP tears.

I'm also interested in finding out if there are any studies which have shown if conservative treatment has been beneficial with treating SLAP tears and the labrum eventually heals by itself.

I'd greatly appreciate if someone can point me in the direction of some articles? John can you help with this one?

Thanks

Angie

Hipster
01-06-2007, 09:01 AM
There is quite lot of research coming out of the US regarding SLAP lesion assessment and management. The key indicator of prognosis is basically the classification of the SLAP lesion. The problem is that the gold standard for this assessment is arthroscopy. So you don't really know until you have a look inside. Kevin Wilk is a physical therapist who has written a few good papers on rehab guidelines pre and post surgery. Here is a good summary of some of the work that is being done currently (sadly it doesn't include references).

http://www.hsedu.com/JournalClub/2006/5-25-06.pdf

As a physio I suppose they way I look at SLAP injuries is that you need to follow a diagnostic pathway or paradigm. You work through a conservative management approach and monitor symptoms. If this fails and symptoms are still present (and imaging is inconclusive) then the next positive step would have to be surgical intervention to assess and hopefully repair the lesion.

Now whether as a patient, you want to take that step, depends on a number of factors, including:
- pain and dysfunction level
- education about risks, benefits and expected outcomes of surgery
- an experienced and recommended surgeon
- a good post op rehab plan with clear timeframes and goals

Hope that quick reply gets you thinking, over the weekend I'll do a more thorough search to get you a few references to look through. The more information you have, the better decisions you can make.

angieliu
01-06-2007, 11:51 AM
Thanks Hipster for the advice. I'be had a read of the presentation by Kevin Wilk and it is interesting. I guess the issue is confirming if I definitely have a SLAP and the type. I however am not keen on the 'gold standard' approach to assessing for SLAP tears. I'm probably more concerned with the literature I have read which have said that full ROM is not achieved after surgery.

If that is the case, then I would say that there would be no reason for surgery because my ROM isn't bad at all.

I have done a quick search in the American journal of sports med and will go through those articles on the weekend. If you dig up some more then I'd greatly appreciate if you can forward them on to me.

Thanks

Angie