Imagine placing a basketball on top of a small socket and trying to hold it there. This is how orthopedists describe the glenohumeral joint: the rounded head of the humerus is considered to be the ball and the shallow surface of the glenoid cavity the socket. The primary stabilizers of the glenohumeral joint are the muscles and ligaments, as well as the glenoid labrum, a fibrocartilaginous rim attached around the margin of the glenoid cavity, that increases glenoid depth.
A serious injury in the shoulder girdle occurs when the glenoid labrum is torn, and commonly takes a long time to be diagnosed. SLAP (Superior Labrum Anterior to Posterior) tears are amongst the most common shoulder injuries and – as the term suggests, occur in the superior point where the long head of the biceps tendon attaches to the labrum and forms an exceptionally complex anatomical structure.

Apart from degenerative SLAP tears in elderly patients, SLAP tears are primarily associated with individuals who participate in sports, and in particular, overhead-throwing athletes. In fact, this type of shoulder injury was recorded in medical bibliography for the first time in the 1980s, after a medical research performed on baseball players.
Falling from a standing position onto an outstretched arm or falling on the shoulder, embracing oneself during a motor vehicle accident, repetitive or rapid lifting of a heavy weight, as well as trying to prevent oneself from falling off a horizontal bar, are a number of incidents that can lead to this particular shoulder injury. Despite the fact that symptoms are determined by the size and location of the tear, patients commonly experience widespread pain (making it difficult for the patient to identify the precise cause of pain), pain during specific activities or shoulder movements (especially during overhead arm movements), weakness, or even shoulder instability and ‘‘locking’’ of the joint.

SLAP tears are frequently accompanied by other shoulder injuries, for example rotator cuff tears. Subsequently, despite the detailed medical history taken by the orthopedist and the proper clinical examination of the shoulder, accurate diagnosis might be difficult to make.  In addition, SLAP tears may not be even apparent on an MRI scan. If the symptoms don’t subside, an MR arthrography of the shoulder is performed. Shoulder arthroscopy is necessary in order to obtain accurate diagnosis. During this particular surgical procedure, the torn glenoid labrum is repaired, often with the use of bioabsorbable anchors. 

Conventional treatment is initially recommended and involves activity modifications, physiotherapy sessions and anti-inflammatory drugs in order to relieve pain. In relation to the degree of the injury, surgical treatment options consist of debridement of the wound site, reposition and fixation of the glenoid labrum with the use of suture anchors, and biceps tenotomy or tenodesis of the long head of the biceps.

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