Comparison of Treatment Outcomes After Arthroscopic Repair and Biceps Tenotomy in Patients with Isolated Slap Lesions

Objective: We compared the clinical outcomes after arthroscopic repair to those after biceps tenotomy in patients with isolated superior labrum anterior posterior (SLAP) Type 2-3 lesions. Methods: A total of 48 patients with isolated SLAP Type 2-3 lesions, who underwent either arthroscopic repair (n=024) or tenotomy (n=24) were included in the study. CONSTANT shoulder scores in the postoperative 40th month were compared between both groups. Tenotomy was performed for the second time in 6 patients who did not benefit from arthroscopic repair, and their CONSTANT scores estimated before and 12 months after tenotomy were compared. Results: The clinical outcomes were evaluated in the arthroscopic repair group. Preoperative and postoperative CONSTANT scores were 43.87 (8.32), and 71.41 (9.75) (p<0. 001), respectively. In the tenotomy group pre-, and postoperative CONSTANT scores were 40.25(8.63), and 90.04 (4.04) (p<0.001), respectively. There was not a significant difference between the two groups in terms of the preoperative scores (p=0.146), however, the comparison of the postoperative scores revealed a significant difference (p<0.001). The mean CONSTANT score was 50.3 (±5.64) at the end of 27th month, and the mean postoperative CONSTANT score was 86.8 (±7.16) at the 12th month in six patients whose complaints did not resolve and underwent repeat arthroscopic tenotomy (p<0.001). Conclusion: In our opinion, there is no criterion for repair or tenotomy in isolated SLAP lesions. In these patients, tenotomy may be preferred in the first place because it results in more favourable outcomes compared to repair. The cause of the pain that persists after repair of the SLAP lesion should not be considered as an incorrect, inadequate repair or a complication. In the first place, intolerable biceps tendinitis should be considered.