Outcome of Arthroscopic Repair of Type II SLAP Lesions in Worker’s Compensation Patients


Nikhil N. Verma, MD, Ralph Garretson, MD, Anthony A. Romeo, MD
From the Section of Sports Medicine
Department of Orthopaedic Surgery, Rush Medical College, Chicago, IL
Rush-Presbyterian-St. Luke’s Medical Center

Abstract
Purpose:
Arthroscopic stabilization has become the accepted treatment for Type II superior labral anterior and posterior (SLAP) lesions.  Short-term results using a variety of techniques have been promising, but most reports focus on motivated athletes.  The purpose of our report is to evaluate the results of arthroscopic fixation of type II SLAP lesions in 21 patients who suffered a work-related injury and are receiving workers’ compensation.  The hypothesis was that in patients with a single event trauma who were receiving workers’ compensation, clinical results would be inferior to those previously reported.

Methods: Twenty-two consecutive worker’s compensation patients with Type II superior labral anterior and posterior (SLAP) lesions underwent arthroscopic stabilization between October, 1994 and December, 1996.  All patients received suture anchors with nonabsorbable suture secured around the labrum for definitive fixation.  Average age at surgery was 43 and average follow-up time was 27.9 months.  Seventeen patients (89%) had an acromioplasty at the time of labral stabilization.  Outcome was assessed by analysis of Visual Analog Pain Scale, Simple Shoulder Test (SST) and general health status questionnaire (SF-36), subjective patient satisfaction, and ability to return to work.

Results: Visual analog pain scales improved by an average of 3 points although all patients had significant complaints of pain at follow-up.  Simple shoulder test responses showed improvement in 9 out of 12 categories.  The SF-36 results showed significant improvements only in the bodily pain and role-physical categories.  Five patients required re-operation for persistent pain. However, only 7 patients (437%) returned to work at their previous functional level, 9 patients (47%) returned to work but at less strenuous jobs, and 3 patients (16%) did not return to work.

Conclusions: Currently recommended treatment for Type II SLAP lesions is arthroscopic stabilization.  When this procedure is performed in worker’s compensation patients a with single event trauma to the shoulder, objective parameters as well as patient self-assessment surveys do show improvement. However, results are inferior to those previously reported in the literature.

This article appears in HSS Journal: Volume 3, Number 1.
View the full article at springerlink.com.


About the HSS Journal
HSS Journal, an academic peer-reviewed journal, is published twice a year, February and September, and features articles by internal faculty and HSS alumni that present current research and clinical work in the field of musculoskeletal medicine performed at HSS, including research articles, surgical procedures, and case reports.


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