University of California San Diego, San Diego, California, USA.
Rady Children's Hospital, San Diego, California, USA.
Am J Sports Med. 2020 Mar;48(4):959-965. doi: 10.1177/0363546519900162. Epub 2020 Feb 5.
Adolescent athletes are at risk of sustaining an injury to the posterior and superior labrum of the glenoid. Limited information is available regarding the outcomes of surgical intervention in this specific age cohort.
To compare those patients with pure posterior pathology and those with posterior labral tears that involve the biceps anchor (superior labrum anterior-posterior [SLAP] tears) to determine risks for failure in the surgical management.
Cohort study; Level of evidence, 3.
A retrospective review was performed on all patients under the age of 19 years over an 8-year period to identify those treated for superior and posterior labral pathology, followed by chart review, radiographic review, and arthroscopic findings. Patient characteristics and other variables were recorded, including cause (traumatic vs atraumatic), activity/sports (overhead vs nonoverhead), involvement of the biceps anchor-crossing the 12-o'clock position (posterior vs SLAP), associated pathologies, outcome scores (Single Assessment Numerical Evaluation [SANE] and Pediatric/Adolescent Shoulder Survey [PASS] scores), and complications.
Forty-eight patients (30 boys, 18 girls) with a mean age at surgery of 16.5 years (range, 13.5-19 years) were identified who met criteria, with a mean follow-up of 4.1 years (range, 1.3-6.9 years). Nineteen patients had SLAP tears and 29 patients had posterior tears. All but 2 regularly participated in sports at the time of their injury; of the athletes, 26 (56.5%) played an overhead sport and 20 (43.5%) played a nonoverhead sport. The cause of the injury was traumatic in 25 cases (52.1%) and atraumatic in 23 cases (47.9%). Outcome scores were not significantly different between cause or type of sports played; SANE scores were not significantly different by tear type (mean SLAP score, 88.4 compared with mean posterior score, 80.9; = .124); but the mean PASS score in the SLAP group was 88.7, compared with 76.2 in the posterior group ( = .005) at final assessment. Only 1 SLAP patient had failed management (5.3%) compared with 5 patients in the posterior-only cohort (17.2%).
Posterior SLAP tears have better outcomes and lower failure rates than posterior-only tears in the adolescent population. Posterior-superior labral tears can occur in all sports types with multiple causes, but the only factor that appears to play a role in ultimate outcome is whether the tear crosses under the biceps anchor to the anterior side.
青少年运动员有受伤的风险，包括肩盂后上唇和上唇前-后（SLAP）撕裂。关于这个特定年龄段的手术干预结果，信息有限。
比较单纯后唇病变和涉及二头肌锚定（SLAP 撕裂）的后唇撕裂患者，以确定手术管理失败的风险。
队列研究；证据水平，3 级。
对 8 年内所有年龄在 19 岁以下的患者进行回顾性分析，以确定接受上后唇病变治疗的患者，然后进行图表审查、影像学审查和关节镜检查。记录患者特征和其他变量，包括病因（创伤性与非创伤性）、活动/运动（过顶与非过顶）、二头肌锚定的受累情况（越过 12 点位置的后唇与 SLAP）、相关病变、结局评分（单一评估数值评估[SANE]和小儿/青少年肩部调查[PASS]评分）和并发症。
确定了 48 名符合标准的患者（30 名男孩，18 名女孩），平均手术年龄为 16.5 岁（范围 13.5-19 岁），平均随访 4.1 年（范围 1.3-6.9 年）。19 名患者有 SLAP 撕裂，29 名患者有后唇撕裂。受伤时，除 2 例患者外，所有患者均定期参加运动；在运动员中，26 名（56.5%）从事过顶运动，20 名（43.5%）从事非过顶运动。25 例（52.1%）为创伤性病因，23 例（47.9%）为非创伤性病因。病因或运动类型对结局评分无显著影响；SANE 评分与撕裂类型无显著差异（平均 SLAP 评分 88.4 与平均后唇评分 80.9； =.124）；但 SLAP 组的最终 PASS 评分为 88.7，而后唇组为 76.2（ =.005）。只有 1 例 SLAP 患者（5.3%）治疗失败，而后唇组有 5 例（17.2%）。
在青少年人群中，SLAP 后唇撕裂的结局更好，失败率更低。后上唇撕裂可发生于所有运动类型，病因多样，但似乎只有撕裂是否越过二头肌锚定到前侧这一因素与最终结局有关。
