Suprapectoral biceps tenodesis achieves better short clinical outcomes than labral repair for type V SLAP lesions in active-duty military patients with shoulder instability after Bankart repair.

PURPOSE: To compare the outcomes of arthroscopic Bankart repair combined with arthroscopic SLAP repair and arthroscopic Bankart repair combined with Suprapectoral biceps tenodesis in active-duty military individuals with type V SLAP lesions.

METHODS

From June 2015 to April 2022, we treated a total of 243 patients with shoulder joint instability. According to the inclusion and exclusion criteria, 70 patients with type V SLAP lesions who underwent Bankart repair surgery simultaneously with arthroscopic SLAP repair or combined with biceps tenodesis and who were followed up for at least 2 years were included in the study. The clinical data of 38 patients who underwent Bankart repair combined with arthroscopic SLAP repair (repair group) were compared with those of 32 patients who underwent arthroscopic Bankart repair combined with Suprapectoral biceps tenodesis (tenodesis group). The findings of the preoperative and postoperative clinical assessments, physical examination, injury mechanism assessment, and magnetic resonance imaging (MRI) examination were reviewed. Patient-reported disabilities of the arm, shoulder, and hand (DASH) scores, Western Ontario Shoulder Instability Index (WOSI) scores, American Shoulder and Elbow Surgeons (ASES) scores, and visual analog scale (VAS) scores for pain and satisfaction were evaluated.

RESULTS

There was no significant difference between the groups in terms of preoperative range of motion or outcome evaluations. At the last follow-up, both groups demonstrated improvements in DASH, ASES, WOSI, and VAS scores compared to preoperative assessments. the tenodesis group demonstrated a potential trend toward clinically meaningful improvement in both WOSI and DASH scores compared to the repair group. There was no significant difference in shoulder joint mobility, ASES score, or VAS score between the two groups.

CONCLUSION

Both arthroscopic Bankart repair combined with Suprapectoral biceps tenodesis and arthroscopic Bankart repair combined with SLAP repair can effectively treat type V SLAP lesions in military individuals, both postoperative clinical outcomes and pain scores demonstrated improvement. Our research results indicated that bicipital tenodesis combined with anterior labral repair might serve as an effective alternative to arthroscopic type V SLAP repair in active-duty military patients with type V lesions. LEVEL OF EVIDENCE: Level III.