Surgical treatment of SLAP tears: labrum repair versus biceps tenodesis. A systematic review
DOI:
https://doi.org/10.58814/01208845.582Keywords:
SLAP Tears, Tenodesis, Repair, Systematic Review, Meta-analysisAbstract
Introduction: In the past, biceps tenodesis was the go-to technique for treating SLAP lesions in older patients with lower functional demands, while arthroscopic labrum repair was preferred in young, active individuals. However, there is still debate about which technique to select.
Objective: To compare the efficacy and safety of biceps tenodesis and labrum repair in the treatment of SLAP tears.
Methodology: This systematic review and meta-analysis adhered to the PRISMA 2020 guidelines. Systematic searches were conducted in December 2024 in Medline (PubMed), Web of Science, and Cochrane to find clinical trials and observational studies published in the last 10 years that compared both treatments in terms of efficacy and safety. The meta-analysis was performed in RevMan using a fixed-effect model when heterogeneity was <50% and a random-effects model if it was >50%. A statistical significance level of p<0.05 was considered.
Results: Ten retrospective observational (cohort) studies were included. The mean age in both groups was <40 years in six studies and ≥40 years in three. In the remaining study, the mean age was <40 years in the tenodesis group and ≥40 years in the labrum repair group. Postoperative pain (VAS score) was significantly lower in patients who underwent tenodesis [mean difference (MD): -0.29, 95%CI: -0.50 to -0.07, p=0.010]. No differences were found between groups in the ASES score (MD: 0.72, 95%CI: -1.61 to 3.05, p=0.54), the rate of return to sports (RR: 1.08, 95%CI: 0.97 to 1.21, p=0.15), or the reoperation rate (RR: 0.41, 95%CI: 0.17 to 1.01, p=0.05).
Conclusions: Regardless of age, there are no significant differences between biceps tenodesis and labrum repair for the treatment of SLAP tears in terms of the patient’s subjective perception on functional scales, rate of return to sports activity, and reoperation rate. Postoperative pain was significantly lower in the biceps tenodesis group.
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