Comparison of surgical techniques for repair of SLAP injuries in the shoulder

Abstract

Introduction: SLAP (Anterior Posterior-Posterior Upper Labral) injuries in the shoulder are common in athletes and physically active individuals, often requiring surgical intervention to restore function and relieve pain. This systematic review compared different surgical techniques, such as tenodesis and labral repair, evaluating functional outcomes, postoperative complications, and rehabilitation efficacy. Methods: Randomized, observational studies, systematic reviews, and meta-analyses of patients with SLAP lesions submitted to various surgical techniques were included. Searches were conducted in databases such as PubMed, MEDLINE, Embase, and Cochrane. Methodological quality was assessed using the ROB 2 and ROBINS-I tools, and heterogeneity was analyzed using the I² index. Results: Patients under 40 years of age had better results with labral repair, while those over 40 years of age had superior outcomes with tenodesis. Arthroscopic techniques were associated with shorter recovery time and fewer complications compared with open techniques, especially in complex lesions. Rehabilitation, particularly hydrotherapy, has been shown to significantly improve pain control and range of motion. Heterogeneity between studies was moderate to high (I² = 65%), with the risk of bias being low in most included studies. Conclusion: The choice of surgical technique should be personalized, considering factors such as age, type of injury, and patient goals. Labral repair is recommended for younger patients, while tenodesis may be more suitable for older patients. Arthroscopic techniques offer advantages in terms of recovery and complications, and proper rehabilitation is crucial for postoperative success. Future studies should focus on high-quality randomised controlled trials to improve the available evidence.