Arthroscopic SLAP Repair Surgery: A Minimally Invasive Solution

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Arthroscopic SLAP repair is a minimally invasive surgical procedure performed to address Superior Labrum Anterior and Posterior tears, which involve injury to the superior labrum of the shoulder where the long head of the biceps tendon attaches. The procedure begins with patient positioning in lateral decubitus or beach chair position, followed by establishment of a standard posterior viewing portal. A diagnostic arthroscopy confirms the SLAP lesion, after which anterior and anterosuperior working portals are created.

The surgical technique involves debridement of frayed labral tissue and preparation of the superior glenoid rim. Suture anchors, typically 2-3, are placed into the superior glenoid, followed by suture passage through labral tissue. The labrum is then securely fixed to restore normal anatomy, concluding with final inspection and closure.

This procedure is indicated for symptomatic SLAP tears unresponsive to conservative treatment, particularly in athletes involved in overhead activities and active individuals with mechanical symptoms who have documented labral pathology on imaging. Contraindications include advanced glenohumeral arthritis, significant rotator cuff pathology, active infection, and medical conditions that preclude surgery.

The post-operative protocol spans several months, beginning with sling immobilization and passive range of motion exercises in the first four weeks. Weeks 4-8 progress to active-assisted range of motion and initial rotator cuff strengthening. Advanced strengthening and sport-specific exercises begin at weeks 8-12, with full return to activities occurring between 3-6 months.

Success rates range from 85-90% in appropriate candidates, with return to pre-injury activity levels typically achieved in 6-9 months. Younger patients generally experience better outcomes, though results can vary in overhead athletes. Potential complications include stiffness, persistent pain, hardware complications, failed repair, infection, nerve injury, and complex regional pain syndrome.

Key success factors include proper patient selection, technical precision, appropriate post-operative rehabilitation, patient compliance, early intervention, and surgeon experience. Long-term management requires regular follow-up during the first year, activity modification as needed, maintenance exercise program, monitoring for recurrence, and implementation of prevention strategies for future injury.