SLAP Lesion Physiopedia. Search Strategy. Databases. Pub. Med PEDro Public library Google Scholar. Web of Science. Keywords. SLAP lesion SLAP tear superior labral anterior posterior tear biceps anchor tear. DefinitionDescription. PMC3269387_1477-7525-9-111-5.png' alt='Eq-5D Scoring Manual' title='Eq-5D Scoring Manual' />Background As more patients survive the acute respiratory distress syndrome, an understanding of the longterm outcomes of this condition is needed. Methods We. Tears of the superior labrum near to the origin of the long head of biceps were first described among throwing athletes by Andrews in 1. LOE 5 The label of SLAP, an abbreviation for superior labrum anterior and posterior, was coined by Snyder et al, who went on to create a classification system for these lesions. LOE 5 A total of four types of superior labral lesions involving the biceps anchor have been identified. Type I concerns degenerative fraying with no detachment of the biceps insertion. Type II is the most common type and represents a detachment of the superior labrum and biceps from the glenoid rim. Type III represents a bucket handle tear of the labrum with an intact biceps tendon insertion to the bone. Finally, type IV lesions, the least common type represents an intra substance tear of the biceps tendon with a bucket handle tear of the superior aspect of the labrum. LOE 5. The Type II SLAP lesions have been further divided into three subtypes depending on whether the detachment of the labrum involves the anterior aspect of the labrum alone, the posterior aspect alone, or both aspects. B/2/210/F2.medium.gif' alt='Eq-5D Scoring Manual' title='Eq-5D Scoring Manual' />Nivolumab versus standard, singleagent therapy of investigators choice in recurrent or metastatic squamous cell carcinoma of the head and neck CheckMate 141. The above classification system has been expanded to include an additional three types 7 LOE 5. Type V a Bankart lesion that extends superiorly to include a Type II SLAP lesion. Type VI an unstable flap tear of the labrum in conjunction with a biceps tendon separation. Type VII a superior labrum and biceps tendon separation that extends anteriorly, inferior to the middle glenohumeral ligament. LOE 5Recently Nord and Ryu have added several previously unclassified lesions to the classification scheme. A Type VIII SLAP lesion is a SLAP extension along the posterior glenoid labrum as far as 6 oclock. A Type IX lesion is a pan labral SLAP injury extending the entire circumference of the glenoid. A Type X lesion is a superior labral tear associated with posterior inferior labral tear reverse bankart lesion. LOE 5Clinically Relevant Anatomy. The shoulder complex is one of the most sophisticated areas of the body. The shoulder is made up of five joints the Acromioclavicular Joint, the Sternoclavicular Joint, the Glenohumeral Joint, Scapulothoracic Joint and Suprahumeral Joint and four linked bone groups the clavicula, sternum, Scapula and the humerus which are related and work together. LOE 5The major joint is the Glenohumeral Joint, which is also called the ball in a socket joint because of the humeral head ball that articulates with the glenoid cavity glenoid fossa of scapula or socket. LOE 5. But the humeral head is larger than the fossa and so the socket covers only a quarter of the humeral head. LOE 5 3. 2 LOE 5A circumflexial rim of fibrocartilaginous tissue called labrum glenoidalis firmly attaches to the glenoid fossa thereby increasing the articular surface area and the stabilisation of the glenohumeral joint. LOE 2. C 3. 2 LOE 5. The long arm of the biceps inserts directly into the superior labrum, which also provides stabilisation to the superior part of the joint. LOE 3. A 5 LOE 5 In addition, the rotatorCuff muscles are essential to ensure dynamic shoulder stability as they prevent excessive translations of the humeral head at the level of the glenoid fossa. New York Bottom Rocker Patch. LOE 4. Important variations in the normal anatomy of the labrum have been identified. Three distinct variations occur in over 1. The identification of these normal variants can help to prevent the misdiagnosis of labral lesions. Scott E. Powell et al. LOE 3. AEpidemiologyEtiology. The age of the patient has an impact on the superior labrum. From the average age of 3. In the age category 3. In the age category 6. Thus, we can conclude that there is an age related effect in which the older the patient is, the more likely he will incur a SLAP lesion, due to age related changes. LOE 2. CIn one study, half of the cases that had a SLAP lesion were 4. Most of them had a type II SLAP lesion. They also noticed that the type II SLAP lesions in patients under 4. II SLAP lesion in patients under 4. SLAP lesion were associated with a tear of the supraspinatus tendon and osteoarthritis of the humeral head. LOE 3. A. There are a lot of different mechanisms of injury that can result in a SLAP lesion. The following causes have been found repetitive throwing, hyperextension, a fall on an outstretched arm, heavy lifting, direct trauma. The two most common mechanisms are falling on an outstretched arm in which there is a superior compression, and a traction injury in the inferior direction. LOE 3. A. Falling on an outstretched arm is an acute traumatic superior compression force to the shoulder. In this situation the shoulder is abducted and slightly forward flexed at the time of the impact. A subsequent study found that the most common mechanism of injury was a fall or direct blow to the shoulder, occurring in 3. A significant number of patients with superior glenoid lesions and concomitant impingement or rotator cuff disease in the absence of trauma has also been identified. Indeed, Snyder et al found partial thickness or full thickness rotator cuff disease in 5. SLAP lesions. Superior migration of the humeral head can result from a rotator cuff that is not effectively performing its role as a humeral head depressor. The superior labrum and biceps anchor could theoretically be gradually lifted off the glenoid as a result of chronic repetitive superior translation of the humeral head on the glenoid rim. Other authors supported the theory of an inferior traction mechanism on the basis of a sudden, traumatic, inferior pull on the arm or repetitive microtrauma from overhead sports activity with associated instability. LOE5Throwers can have repetitive microtraumata. At the moment of the impact the glenohumeral contact point is shifted posterosuperiorly and increased shear forces are placed on the posterior superior labrum, which results in a peel back effect and eventually in a SLAP lesion. LOE 3. ACharacteristicsClinical Presentation. The most common complaint in patients that present with SLAP lesions is pain. Pain is typically intermittent and often associated with overhead movements. LOE 5 Isolated SLAP lesions are uncommon. LOE 4 The majority of patients with SLAP lesions will also complain of sensations of painful clicking andor popping with shoulder movementloss of glenohumeral internal rotation range of motionpain with overhead motionsloss of rotator cuff muscular strength and enduranceloss of scapular stabiliser muscle strength and enduranceinability to lie on the affected shoulder 2. LOE 5Athletes performing overhead movements, especially pitchers, may develop dead arm syndrome in which they have a painful shoulder with throwing and can no longer throw with pre injury velocity. LOE 3. A They may also report a loss of velocity and accuracy along with discomfort in the shoulder. LOE 5It is important to keep in mind that the scapula is an important factor during shoulder movements. When the scapula does not perform its action properly there is a scapular malposition. This decreases the normal shoulder function. LOE 3. A 2. 2 LOE 3. A It changes the activation of the scapular stabilising muscles. HRA Publications. KeyLIDO. Publications        Underlined Publications. PDFs. Instrument. Development Publications. Peyrot M, Bushnell DM, Best JH, Martin ML, Patrick. DL.  The Self Management Profile for Type 2 Diabetes SMP T2. D. Measurement properties of a new measure of diabetes specific. Health and. Quality of Life Outcomes 1. Rocha. NS, Power MJ, Bushnell DM, Fleck MP. The EUROHIS QOL 8 item Comparative. WHOQOL BREF. Value in Health, 1. Bushnell DM, Martin ML, Moore KA. Richter HE, Rubin A, Patrick DL. Menorrhagia. Impact Questionnaire Assessing the influence of heavy menstrual bleeding on. Current Medical Research. Opinion 2. 61. 2 2. Brod M, Hammer M, Kragh N. Lessard S, Bushnell DM. Development. and validation of the Treatment Related Impact Measure of Weight TRIM Weight. Health and Quality of Life Outcomes 8 1. M, Christensen T, Kongs JH, Bushnell DM. Examining and. Diabetes Medication Satisfaction. Measure Diab. Med. Sat.   Journal of Medical Economics 1. Martin ML, Patrick DL, Bushnell DM, Meltzer EO, Gutierrez B, Parasuraman. B.   Development of the Asthma Treatment Satisfaction Measure. Current. Medical Research Opinion 2. Oct 2. 00. 9. Epub ahead of. August 1. 9, 2. 00. Symonds T, Perelman MA. Althof S, Giuliano F, Martin M, May. K, Abraham L, Crossland A, Morris M. Development and Validation of a Premature. Ejaculation Diagnostic Tool. European. Urology 5. Patrick DL, Bushnell DM, Rothman M. Performance of two self report measures for evaluating obesity and weight. Obesity Research 1. Patrick DL, Martin ML, Bushnell DM, Pesa. J.   Measuring satisfaction with migraine treatment. Clinical. Therapeutics 2. Niero M, Martin ML, Finger T, Lucas R, Mear. I, Wild D, Glauda L, Patrick DL. Multi Cultural Development of Two New. Obesity specific Health Related Quality of Life and Symptom Measures The. OWLQOL Obesity and Weight Loss Quality of Life Instrument and the WRSM. Weight Related Symptom Measure. Program Grafik Komputer. Clinical Therapeutics 2. Patrick DL, Martin. ML, Buesching DP. Evaluating. the Impact of Urinary Incontinence and Its Treatment. Medical. Outcomes Trust for MOT Bulletin. Fall 2. 00. 0. Bonomi AE. Patrick DL, Bushnell DM, Martin ML. Validation of the. United States version of the World Health Organization Quality of Life. WHOQOL instrument. J Clinical. Epidemiology 5. Bonomi AE. Patrick DL, Bushnell DM, Martin ML. Quality of life. measurement Will we ever be satisfied J Clinical Epidemiology 5. Hogan T. Grimaldi R, Dingemanse J, Martin ML, Lyons K, Koller W. The Parkinsons. disease symptom inventory PDSI A comprehensive and sensitive. Parkinsonism Related Disorders. Patrick DL, Martin. ML, Bushnell DM. The I QOL A quality of life instrument. Users manual and scoring. United. States version. Seattle, Washington. Health Research Associates, Inc., 1. Patrick DL, Martin. ML, Bushnell DM, Yalcin I, Wagner TH, Buesching DP. Quality of. life of women with urinary incontinence Further development of the. I QOL. Urology 5. Patrick DL, Martin. ML, Bushnell DM. A quality of life measure for persons with. Users manual and scoring diskette for United States version. Seattle, Washington. Health Research Associates, Inc., 1. Qualitative Research and Cross Cultural Publications. Geister T, Quintanar Solares M, Martin M, Aufhammer S, Asmus F. Qualitative. development of the Questionnaire on Pain caused by Spasticity QPS, a. Quality of Life Research, 2. Rydn A, Martin M, Halling K, Niklasson. A.   Night Time Symptoms and Their Impact on Sleep. Patients with Gastroesophageal Reflux Disease Who Have a Partial Response to. Proton Pump Inhibitors A Qualitative Patient Interview Study. The Patient. Patient Centered Outcomes Research, 64 3. Martin M, Mc. Carrier K, Chiou C, Gordon. K, Kimball A, Van Voorhees A, Gottlieb A, Huang X, Globe D, Chau D, Kricorian G. Viswanathan H. Early development and qualitative evidence of content validity. Psoriasis Symptom Inventory PSI, a patient reported outcome measure. Journal of. Dermatological Treatment 2. Kingery L, Martin ML. Naegeli AN, Khan S, Viktrup L. Content validity of the Benign. Prostatic Hyperplasia Impact Index BII a measure of how urinary. BPH may impact the patient. Int J Clin Pract 2. Gwaltney CJ, Slagle AF, Martin ML. Ariely R, Brede Y. Hearing the voice of the patient Key. British. Journal of Cardiology 1. Koller M, Kantzer V, Mear I, Zarzar K, Martin M. Greimel E, Bottomly A, Arnott M, Kuli D on behalf of the ISOQOL. TCA SIG.   The process of reconciliation Evaluation of guidelines. Expert Review of. Pharmacoeconomics Outcomes Research 1. Patrick DL, Burke LB, Gwaltney C, Kline Leidy N, Martin ML. Molsen E, Ring L. Staffing Level Estimation In Software Engineering. Content Validity   Establishing and. Reporting Evidence in Newly Developed Patient Reported Outcomes PRO. Instruments for Medical Product Evaluation ISPOR PRO Good Research. Practices Task Force Report Part 1Eliciting Concepts for a new PRO. Instrument. Value in Health 1. Patrick DL, Burke LB, Gwaltney C, Kline Leidy N, Martin ML. Molsen E, Ring L. Content Validity   Establishing and. Reporting Evidence in Newly Developed Patient Reported Outcomes PRO. Instruments for Medical Product Evaluation ISPOR PRO Good Research. Practices Task Force Report Part 2Assessing Respondent Understanding. Value in Health 1. Martin ML, Patrick DL, Gandra SR, Bennett AV. Leidy NK, Nissenson AR, Finkelstein FO, Lewis EF, Wu AW, Ware JE. Content validation of two SF 3. Quality of Life. Research 2. Wild D, Eremenco S, Mear I, Martin M, Houchin C. Gawlicki M, Hareendran A, Wiklund I, Chong LY, von Maltzahn R, Cohen L. Molsen E.   Multinational trials. Recommendations on the translations required, approaches to using the. The ISPOR. Patient Reported Outcomes Translation Linguistic Validation Good. Research Practices Task Force Report. Value in Health. 1. Huang W, Zhou F, Bushnell. DM, Diakite C, Yang X. Cultural adaptation and application of the IBS QOL in China. A disease specific quality of life questionnaire. Quality of Life Research 1. Abraham L. Field B, Svihra J, Hareendran A, Martin ML, Bushnell DM. Gong JQ, Levinson I, Streeter J. Electronic diaries Exploring. Drug Information Journal 4. Bailey A, Martin ML, Girman C, Mc. Naughton Collins M, Barry. MJ Development of a Multi Regional US Spanish Translation of the I PSS. BPH Impact Index BII. Urology 1. Wild D, Grove A, Martin ML, Eremenco S, Ford. S, Verjeee Lorenz A, Erikson P ISPOR Principles of Good Practice The Cross Cultural. Adaptation Process for Patient Reported, Value in Health 82 9. Bushnell DM, Martin ML, Summers KH. Svihra J, Lionis C, Patrick DL Quality of Life in Women with Urinary. Incontinence Cross Cultural Performance of 1. Language Versions of the. I QOL. Quality of Life Research. Niero M, Martin ML, Finger T, Lucas R, Mear. I, Wild D, Glauda L, Patrick DL. Multi Cultural Development of Two New. Obesity specific Health Related Quality of Life and Symptom Measures The. OWLQOL Obesity and Weight Loss Quality of Life Instrument and the WRSM. Weight Related Symptom Measure. Clinical Therapeutics 2. Patrick DL, Martin. ML, Bushnell DM, Marquis P, Andrejasich CM, Buesching DP. Cultural adaptation of a quality of life measure for urinary. European Urology. Wagner TH. Patrick DL, Bavendam TG, Martin ML, Buesching DP. Quality of life. of persons with urinary incontinence Development of a new measure. Urology 4. 71 6. Patrick DL. Wild DJ, Johnson ES, Wagner TH, Martin ML. Cross cultural. validation of quality of life measures.