Although overhead throwing athletes with isolated SLAP tears typically have encouraging prognoses for returning to previous playing levels, a recently presented study shows that those with concomitant SLAP and infraspinatus tears are less likely to experience similar success.
Jonathan P. Van Kleunen, MD, shared his team’s findings at the 2011 Annual Meeting of the Arthroscopy Association of North America, in San Diego.
Van Kleunen added, however, that there has been limited discussion regarding concomitantinfraspinatus tendon tear in the same population. Presence of a concomitant infraspinatus tear has served as an indicator for a more guarded prognosis, he said, and may be a negative predictor for returning to pre-injury level of play.
The team performed a retrospective review on a series of overhead athletes who had been diagnosed with and undergone surgical treatment of both a SLAP tear and a significant — defined in the study as being greater than 50% — tear of the infraspinatus tendon. They were able to identify 20 overhead, high-level throwing athletes younger than 25 years of age who met the study criteria, having undergone simultaneous arthroscopic repairs of a SLAP tear with standard suture anchor technique and an infraspinatus tear with PDS suture between 2005 and 2008.
According to Van Kleunen, all 20 patients in the study made an attempt to return to their prior sport after the completion of postoperative rehabilitation. Of the 20 patients, only five (25%) were able to return to a similar or superior level of performance they had experienced prior to injury. Among the remaining 15 patients, six returned to play at a lower level. These patients were able to play the same position or forced by a decline in throwing velocity to switch to another position, the abstract noted. Nine of the 20 patients were unable to return to play. There were no reported complications or reoperations.
Van Kleunen’s team concluded through their study that significant — meaning greater than 50% — tears of the infraspinatus in combination with GIRD and SLAP tears caused a significant worsening of the prognosis in same-level return to play for overhead throwing athletes.
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