SLAP (Superior Labrum Anterior to Posterior) repair is an arthroscopic operation to reattach the torn superior labrum in the shoulder, where the biceps tendon attaches. It is performed for shoulder pain and instability caused by a SLAP tear.
The operation is performed arthroscopically through small incisions around the shoulder. The torn labrum is identified and reattached to the bone using small suture anchors. In some patients, particularly those over 35, a biceps tenodesis (reattaching the biceps tendon to the humerus instead of repairing the labrum) may be a better option. The operation takes one to one and a half hours.
SLAP repair is considered for active patients with symptomatic SLAP tears causing deep shoulder pain, catching, or popping, particularly overhead athletes (throwers, swimmers). The diagnosis should be confirmed with MR arthrogram and clinical examination.
Physiotherapy focusing on rotator cuff and scapular stabiliser strengthening, activity modification, and anti-inflammatory medication. Many SLAP tears are incidental findings on MRI and do not require surgery.
MR arthrogram for diagnosis. Standard pre-assessment.
Relief of pain and mechanical symptoms. Return to overhead sport is achievable in approximately 70–80% of athletes, though return to pre-injury level is not guaranteed, particularly in throwing athletes.
Shoulder stiffness, particularly loss of external rotation, is common after SLAP repair.
Not all patients achieve complete relief, particularly overhead athletes.
Post-operative discomfort is expected for several weeks.
The labrum may re-tear.
Painful stiffness that can develop after surgery.
Rare.
Shoulder joint infection.
General anaesthesia with a nerve block for pain relief.
Sling for four to six weeks. Gentle exercises begin within the first week. Active movement from six weeks. Strengthening at three months. Return to non-overhead sport at four to six months. Return to overhead sport at six to nine months. Full recovery takes nine to twelve months.
Reviews at two weeks, six weeks, three months, and six months. Physiotherapy throughout.
In patients over 35 or those with significant biceps tendon wear, tenodesis often provides more reliable results with faster recovery. Your surgeon will recommend the best option for you.
Return to throwing is possible but not guaranteed. Approximately 70–80% of overhead athletes return to sport, though not all return to their pre-injury level.