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SLAP (superior labrum anterior posterior) Lesions

The socket (glenoid) in the shoulder has a rim of cartilage (labrum) which acts to enhance the stability of the joint (chock block) and for attachment of other structures (ligaments and tendons).

At the top end of the socket (12 o’clock), the long head of biceps tendon attaches. Injuries here can cause a tear in the labrum extending to either side of the 12 o’clock position.

These are commonly the results of injury or repetitive activities. They can however be degenerate as well. They produce pain and ‘clicking’. Various tests have been described but these are not very specific (Obrien’s and SLAP apprehension tests). An MRI scan with injection of dye (arthrogram) is required to confirm the diagnosis.

If conservative management with physiotherapy and activity modification fails, then key hole surgery is performed to reattach the torn labrum. There will be restriction in movement for the first 6 weeks.

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