The relationship of superior labralanteroposterior (SLAP) lesions and pseudolaxity to shoulder injuries in the overhead athlete

Understanding the effect of superior labral lesions on the function of the shoulder is essential to successfullytreating the overhead athlete. Recognizing the pseudolaxity owing to superior labral anteroposterior (SLAP) lesions and the pathological "peel-back" sign is critical in evaluating the injured shoulder in general and repairing the SLAP lesion in particular. The mechanical characteristics of suture anchors are more favorable than tacks in resisting the pathological forces responsible for the peel-back mechanism. The higher success rate of arthroscopic suture anchor repair of SLAP lesions in comparison with open capsulolabral reconstruction suggests that SLAP lesions are the usual cause of the "dead arm" syndrome. In our experience, arthroscopic repair of SLAP lesions can return the overhead athlete to their preoperative level of function in the vast majority of cases (87% return to preoperative level for two or more seasons).