Skip to main content
Erschienen in: Current Reviews in Musculoskeletal Medicine 1/2018

17.01.2018 | Injuries in Overhead Athletes (J Dines and C Camp, section editors)

Diagnosis and Treatment of Injuries to the Biceps and Superior Labral Complex in Overhead Athletes

verfasst von: Jacob G. Calcei, Venkat Boddapati, David W. Altchek, Christopher L. Camp, Joshua S. Dines

Erschienen in: Current Reviews in Musculoskeletal Medicine | Ausgabe 1/2018

Einloggen, um Zugang zu erhalten

Abstract

Purpose of Review

This review discusses the diagnostic and treatment challenges presented by injuries to the biceps and superior labral complex.

Recent Findings

A focused patient history, numerous physical examination maneuvers, and appropriate advanced imaging studies must be utilized to reach an accurate diagnosis. Nonoperative management, even in overhead athletes, has demonstrated relatively good outcomes, while operative outcomes have yielded mixed results. The surgeon must take into account a number of variables when choosing the appropriate surgical procedure: labral repair versus biceps tenodesis. Rehabilitation, either as nonoperative management or as a postoperative protocol, should focus on restoring glenohumeral and scapulothoracic strength, endurance, and full, pain-free range of motion, while correcting any deficiencies in balance or rhythm throughout the overhead motion.

Summary

Despite the operative treatment challenges that SLAP tears present, with new techniques and proper patient selection, overhead athletes with injuries to the biceps and superior labrum complex can return to sport at a high level.
Literatur
1.
Zurück zum Zitat Patterson BM, Creighton RA, Spang JT, Roberson JR, Kamath GV. Surgical trends in the treatment of superior labrum anterior and posterior lesions of the shoulder: analysis of data from the American Board of Orthopaedic Surgery Certification Examination Database. Am J Sports Med. 2014 Aug;42(8):1904–10. https://doi.org/10.1177/0363546514534939.CrossRefPubMed Patterson BM, Creighton RA, Spang JT, Roberson JR, Kamath GV. Surgical trends in the treatment of superior labrum anterior and posterior lesions of the shoulder: analysis of data from the American Board of Orthopaedic Surgery Certification Examination Database. Am J Sports Med. 2014 Aug;42(8):1904–10. https://​doi.​org/​10.​1177/​0363546514534939​.CrossRefPubMed
4.
17.
Zurück zum Zitat Wilk KE, Macrina LC, Cain EL, Dugas JR, Andrews JR. The recognition and treatment of superior labral (slap) lesions in the overhead athlete. Int J Sports Phys Ther. 2013;8(5):579–600.PubMedPubMedCentral Wilk KE, Macrina LC, Cain EL, Dugas JR, Andrews JR. The recognition and treatment of superior labral (slap) lesions in the overhead athlete. Int J Sports Phys Ther. 2013;8(5):579–600.PubMedPubMedCentral
25.
Zurück zum Zitat • Taylor SA, Newman AM, Dawson C, Gallagher KA, Bowers A, Nguyen J, et al. The “3-pack” examination is critical for comprehensive evaluation of the biceps-labrum complex and the bicipital tunnel: a prospective study. Arthroscopy. 2017;33(1):28–38. https://doi.org/10.1016/j.arthro.2016.05.015. Evaluation of a comprehensive series of physical examination maneuvers (3-pack) in diagnosing biceps and superior labrum complex injuries CrossRefPubMed • Taylor SA, Newman AM, Dawson C, Gallagher KA, Bowers A, Nguyen J, et al. The “3-pack” examination is critical for comprehensive evaluation of the biceps-labrum complex and the bicipital tunnel: a prospective study. Arthroscopy. 2017;33(1):28–38. https://​doi.​org/​10.​1016/​j.​arthro.​2016.​05.​015. Evaluation of a comprehensive series of physical examination maneuvers (3-pack) in diagnosing biceps and superior labrum complex injuries CrossRefPubMed
30.
Zurück zum Zitat • Symanski JS, Subhas N, Babb J, Nicholson J, Gyftopoulos S. Diagnosis of superior labrum anterior-to-posterior tears by using MR imaging and MR arthrography: a systematic review and meta-analysis. Radiology. 2017;285(1):101–13. https://doi.org/10.1148/radiol.2017162681. Study comparing advanced imaging studies (MRI and MR arthrography) in the diagnosis of SLAP tears CrossRefPubMed • Symanski JS, Subhas N, Babb J, Nicholson J, Gyftopoulos S. Diagnosis of superior labrum anterior-to-posterior tears by using MR imaging and MR arthrography: a systematic review and meta-analysis. Radiology. 2017;285(1):101–13. https://​doi.​org/​10.​1148/​radiol.​2017162681. Study comparing advanced imaging studies (MRI and MR arthrography) in the diagnosis of SLAP tears CrossRefPubMed
35.
Zurück zum Zitat • Jang SH, Seo JG, Jang HS, Jung JE, Kim JG. Predictive factors associated with failure of nonoperative treatment of superior labrum anterior-posterior tears. J Shoulder Elb Surg. 2016;25(3):428–34. https://doi.org/10.1016/j.jse.2015.09.008. Recent study examining the factors associated with the failure of nonoperative treatment of SLAP tears CrossRef • Jang SH, Seo JG, Jang HS, Jung JE, Kim JG. Predictive factors associated with failure of nonoperative treatment of superior labrum anterior-posterior tears. J Shoulder Elb Surg. 2016;25(3):428–34. https://​doi.​org/​10.​1016/​j.​jse.​2015.​09.​008. Recent study examining the factors associated with the failure of nonoperative treatment of SLAP tears CrossRef
37.
Zurück zum Zitat • Fedoriw WW, Ramkumar P, PC MC, Lintner DM. Return to play after treatment of superior labral tears in professional baseball players. Am J Sports Med. 2014;42(5):1155–60. https://doi.org/10.1177/0363546514528096. Study evaluating the return to play and return to prior performance of professional baseball players after nonoperative and operative treatment of SLAP tears CrossRefPubMed • Fedoriw WW, Ramkumar P, PC MC, Lintner DM. Return to play after treatment of superior labral tears in professional baseball players. Am J Sports Med. 2014;42(5):1155–60. https://​doi.​org/​10.​1177/​0363546514528096​. Study evaluating the return to play and return to prior performance of professional baseball players after nonoperative and operative treatment of SLAP tears CrossRefPubMed
53.
Zurück zum Zitat Yoneda M, Nakagawa S, Mizuno N, Fukushima S, Hayashida K, Mae T, et al. Arthroscopic capsular release for painful throwing shoulder with posterior capsular tightness. Arthroscopy. 2006;22(7):801. e1-5 CrossRefPubMed Yoneda M, Nakagawa S, Mizuno N, Fukushima S, Hayashida K, Mae T, et al. Arthroscopic capsular release for painful throwing shoulder with posterior capsular tightness. Arthroscopy. 2006;22(7):801. e1-5 CrossRefPubMed
54.
Zurück zum Zitat • Gilliam BD, Douglas L, Fleisig GS, Aune KT, Mason KA, Dugas JR, et al. Return to play and outcomes in baseball players after superior labral anterior-posterior repairs. Am J Sports Med. 2017;1(1):363546517728256–115. https://doi.org/10.1177/0363546517728256. Retrospective review evaluating the rate of return to play and patient reported outcome measures in baseball players of various levels who underwent SLAP repair. • Gilliam BD, Douglas L, Fleisig GS, Aune KT, Mason KA, Dugas JR, et al. Return to play and outcomes in baseball players after superior labral anterior-posterior repairs. Am J Sports Med. 2017;1(1):363546517728256–115. https://​doi.​org/​10.​1177/​0363546517728256​. Retrospective review evaluating the rate of return to play and patient reported outcome measures in baseball players of various levels who underwent SLAP repair.
66.
Zurück zum Zitat • Ek ET, Shi LL, Tompson JD, Freehill MT, Warner JJ. Surgical treatment of isolated type II superior labrum anterior-posterior (SLAP) lesions: repair versus biceps tenodesis. J Shoulder Elb Surg. 2014;23(7):1059–65. https://doi.org/10.1016/j.jse.2013.09.030. Retrospective analysis comparing operative interventions (repair vs. biceps tenodesis) in the treatment of SLAP tears CrossRef • Ek ET, Shi LL, Tompson JD, Freehill MT, Warner JJ. Surgical treatment of isolated type II superior labrum anterior-posterior (SLAP) lesions: repair versus biceps tenodesis. J Shoulder Elb Surg. 2014;23(7):1059–65. https://​doi.​org/​10.​1016/​j.​jse.​2013.​09.​030. Retrospective analysis comparing operative interventions (repair vs. biceps tenodesis) in the treatment of SLAP tears CrossRef
68.
Zurück zum Zitat Griffin JW, Cvetanovich GL, Riboh JC, Leroux TS, Bach BR, Nicholson GP, Cole BJ, Verma, NN, Romeo AA. Biceps tenodesis is a viable option for management of proximal biceps injuries in patients less than 25 years of age. Ortho J Sports Med. 2017 5(3)(suppl 3). doi: https://doi.org/10.1177/2325967117S00116. Griffin JW, Cvetanovich GL, Riboh JC, Leroux TS, Bach BR, Nicholson GP, Cole BJ, Verma, NN, Romeo AA. Biceps tenodesis is a viable option for management of proximal biceps injuries in patients less than 25 years of age. Ortho J Sports Med. 2017 5(3)(suppl 3). doi: https://​doi.​org/​10.​1177/​2325967117S00116​.
69.
Zurück zum Zitat • Chalmers PN, Erickson BJ, Verma NN, Romeo AA. Incidence and return to play after biceps tenodesis in major league baseball players. Ortho J Sports Med. 2017 5(3)(suppl 3). doi: https://doi.org/10.1177/2325967117S00115. Study examining the outcomes in professional baseball players that underwent biceps tenodesis for biceps and superior labral complex injuries . • Chalmers PN, Erickson BJ, Verma NN, Romeo AA. Incidence and return to play after biceps tenodesis in major league baseball players. Ortho J Sports Med. 2017 5(3)(suppl 3). doi: https://​doi.​org/​10.​1177/​2325967117S00115​. Study examining the outcomes in professional baseball players that underwent biceps tenodesis for biceps and superior labral complex injuries .
70.
Zurück zum Zitat • McCormick F, Nwachukwu BU, Solomon D, Dewing C, Golijanin P, Gross DJ, et al. The efficacy of biceps tenodesis in the treatment of failed superior labral anterior posterior repairs. Am J Sports Med. 2014;42(4):820–5. https://doi.org/10.1177/0363546513520122. Evaluation of the use of biceps tenodesis in the revision setting after failed SLAP repair CrossRefPubMed • McCormick F, Nwachukwu BU, Solomon D, Dewing C, Golijanin P, Gross DJ, et al. The efficacy of biceps tenodesis in the treatment of failed superior labral anterior posterior repairs. Am J Sports Med. 2014;42(4):820–5. https://​doi.​org/​10.​1177/​0363546513520122​. Evaluation of the use of biceps tenodesis in the revision setting after failed SLAP repair CrossRefPubMed
Metadaten
Titel
Diagnosis and Treatment of Injuries to the Biceps and Superior Labral Complex in Overhead Athletes
verfasst von
Jacob G. Calcei
Venkat Boddapati
David W. Altchek
Christopher L. Camp
Joshua S. Dines
Publikationsdatum
17.01.2018
Verlag
Springer US
Erschienen in
Current Reviews in Musculoskeletal Medicine / Ausgabe 1/2018
Elektronische ISSN: 1935-9748
DOI
https://doi.org/10.1007/s12178-018-9460-9

Weitere Artikel der Ausgabe 1/2018

Current Reviews in Musculoskeletal Medicine 1/2018 Zur Ausgabe

Injuries in Overhead Athletes (J Dines and C Camp, section editors)

Common Injuries in Professional Football Quarterbacks

Rotator Cuff Repair (M Tao and M Teusink, section editors)

Massive Rotator Cuff Tear: When to Consider Reverse Shoulder Arthroplasty

Injuries in Overhead Athletes (J Dines and C Camp, section editors)

Hip and Groin Injuries in Baseball Players

Injuries in Overhead Athletes (J Dines and C Camp, section editors)

Elbow Injuries in the Adolescent Thrower

Rotator Cuff Repair (M Tao and M Teusink, section editors)

Management of Rotator Cuff Injuries in the Elite Athlete

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.