Is there an association between SLAP lesions and biceps pulley lesions?

Arthroscopy. 2011 May;27(5):611-8. doi: 10.1016/j.arthro.2011.01.005.

Abstract

Purpose: The purpose of this study was to evaluate the prevalence of SLAP and biceps reflection pulley lesions. The hypothesis was that these lesions do not occur concomitantly and they have a different etiology.

Methods: We prospectively analyzed 3,395 shoulder arthroscopies that were independently performed by 2 surgeons between 2004 and 2008 regarding the prevalence of SLAP and biceps pulley lesions. Intraoperative findings were correlated with patient history and clinical examination. Exclusion criteria were type I SLAP lesions, full-thickness rotator cuff tears, and a history of shoulder dislocation.

Results: This study included 182 patients with SLAP lesions (prevalence, 5.4%; 138 men; mean age, 47 years) and 87 patients with pulley lesions (prevalence, 2.6%; 63 men; mean age, 49 years). Isolated SLAP lesions were present in 157 cases, and isolated pulley lesions in 62 cases. The concomitant presence of a SLAP lesion and pulley lesion was significantly rare (10%, P = .003). In 55 (35%; 42 men [76%]; mean age, 43 years) of the cases with isolated SLAP lesions and 40 (65%; 27 men [68%]; mean age, 49 years) with isolated pulley lesions, there was a significant association with history of trauma (P < .01). Most SLAP lesions (32 [58%], P = .174 [not significant]) and most pulley lesions (28 [70%], P < .01) resulted from falling on the outstretched arm with external arm rotation in SLAP lesions and internal rotation in pulley lesions (P > .05).

Conclusions: The concomitant presence of biceps tendon-associated lesions in the form of SLAP and pulley lesions is significantly rare. A history of falling on the abducted and externally rotated arm was typical in patients with SLAP lesions, whereas a fall on the arm with internal rotation was often noted in patients with pulley lesions.

Level of evidence: Level IV, therapeutic case series.

MeSH terms

  • Accidental Falls
  • Adolescent
  • Adult
  • Aged
  • Arthroscopy
  • Athletic Injuries / epidemiology
  • Athletic Injuries / physiopathology
  • Athletic Injuries / surgery
  • Cartilage, Articular / injuries*
  • Cartilage, Articular / surgery
  • Female
  • Humans
  • Joint Instability / epidemiology
  • Joint Instability / physiopathology
  • Joint Instability / surgery
  • Ligaments / injuries*
  • Ligaments / surgery
  • Male
  • Middle Aged
  • Multiple Trauma / epidemiology*
  • Multiple Trauma / surgery
  • Prevalence
  • Prospective Studies
  • Rotator Cuff / surgery
  • Rotator Cuff Injuries
  • Shoulder Joint / injuries*
  • Shoulder Joint / surgery
  • Tendon Injuries / epidemiology*
  • Tendon Injuries / etiology
  • Tendon Injuries / surgery
  • Tendons / physiopathology
  • Tendons / surgery
  • Tenodesis
  • Young Adult