A SLAP lesion refers to a tear of the biceps long head tendon at the top of the shoulder socket--the glenoid. SLAP stands for Superior Labrum Anterior Posterior and there are 4 types. These labral tears cause pain in the front and on top of the shoulder, and are not easily identified with MRI scans--so if there is a high index of suspicion, and symptoms do not improve with therapy, diagnostic arthroscopy is helpful, which allows treatment at the same time.A SLAP tear may contribute to shoulder instability, although this is an area of debate.
Under age 40, repair is typically adviseable, but with increasing age, or when the tendon itself is badly damaged, repair is not a good option since pain may not resolve.In such cases the tendon is released (biceps tenotomy) or tenodesed(sewn to bone). There is an article on this page addressing these options.
SLAP repairs are performed arthroscopically. Postoperatively a sling is worn for 4 weeks. Active elbow flexion is avoided for a few weeks, and shoulder forward flexion and external rotation are also restricted a bit for the first 4 weeks.
