Arthroscopic SLAP Repair

Q1. What is a SLAP tear, and what does an arthroscopic SLAP repair involve?

A SLAP (Superior Labrum Anterior to Posterior) tear is an injury to the ring of cartilage, called the labrum, that surrounds your shoulder socket. This top part of the labrum is also where the biceps tendon attaches. An arthroscopic SLAP repair is a minimally invasive surgery used to reattach the torn cartilage to the bone of the shoulder socket using tiny anchors and sutures, restoring stability to the joint.

Q2. What are the main signs or symptoms that indicate I might need a SLAP repair?

Common symptoms of a SLAP tear include:

• A catching, locking, popping, or grinding sensation in your shoulder.
• Pain when lifting objects, especially overhead.
• A feeling that your shoulder is unstable or might pop out of place.
• A decrease in shoulder strength or range of motion.
• Pain deep within the shoulder, often aggravated by throwing or lifting.

If non-surgical treatments like physical therapy fail to relieve these symptoms, surgery is often recommended.

Q3. How is the surgery performed? Will there be large incisions?

The surgery is performed arthroscopically, which means it is minimally invasive. Instead of large incisions, your surgeon will make two or three tiny keyhole cuts (about the size of a pen tip) around your shoulder. A small camera (arthroscope) and specialized instruments are inserted through these openings to visualize the joint and repair the torn labrum. This results in less pain and quicker healing.

Q4. What type of anesthesia is used for this procedure?

Typically, a combination of general anesthesia and a regional nerve block is used:

• General anesthesia ensures you are completely asleep and pain-free during the surgery.
• A nerve block is an injection near your neck that numbs your shoulder and arm, providing excellent pain relief for 12 to 24 hours after the procedure.

Your anesthesiologist will discuss the best options for you before surgery.

Q5. How long does the arthroscopic SLAP repair surgery take?

The actual surgical procedure usually takes between 45 and 90 minutes. However, you will spend additional time in the pre-operative area preparing for surgery and in the recovery room waking up. You can expect to be at the surgical center for about 4 to 6 hours in total.

Q6. Is this an outpatient procedure, or will I need to stay in the hospital overnight?

Yes, arthroscopic SLAP repair is almost always performed as an outpatient (same-day) procedure. Once you are fully awake, your pain is well controlled, and you can drink fluids and use the restroom, you will be cleared to go home. You must arrange for a responsible adult to drive you home and stay with you for the first night.

Q7. What should I do to prepare for my surgery in the days leading up to it?

To prepare for your surgery:

• Follow fasting instructions: Do not eat or drink anything after midnight the night before.
• Review your medications: Your healthcare team will tell you which medications to stop (like blood thinners or anti-inflammatories) and which to take with a sip of water.
• Arrange help: Set up assistance with daily tasks like cooking, cleaning, and dressing for the first week.
• Prepare easy-to-wear clothing: Choose loose-fitting, button-up shirts and slip-on shoes.

Q8. How is post-operative pain managed after a SLAP repair?

Pain management involves a multi-modal approach to keep you comfortable:

• Nerve block: Provides immediate post-operative numbness.
• Oral medications: A combination of prescription pain relievers, anti-inflammatories, and over-the-counter options (like acetaminophen).
• Ice therapy: Applying ice packs to your shoulder for 20-30 minutes at a time helps reduce swelling and numb pain.
• Positioning: Keeping your torso slightly elevated when resting also reduces throbbing.

Q9. Will I need to wear a sling after surgery? For how long?

Yes, you will need to wear a special shoulder sling (often with a small pillow next to your body) for approximately 4 to 6 weeks. The sling is crucial because it protects the repaired cartilage while it heals back to the bone. You must wear it at all times, including while sleeping, except when showering or performing gentle elbow, wrist, and hand exercises as directed by your surgeon.

Q10. What is the best way to sleep comfortably and safely after a SLAP repair?

Sleeping can be challenging after shoulder surgery. Here are tips to sleep comfortably:

• Sleep semi-reclined: Many patients find it easiest to sleep in a recliner chair or propped up with pillows in bed at a 45-degree angle for the first few weeks.
• Support your arm: Place a small pillow behind your elbow on the surgical side to prevent your shoulder from falling backward.
• Keep the sling on: Ensure your sling is securely fastened to prevent accidental movement of your arm during sleep.

Q11. When can I start physical therapy, and what does the rehabilitation timeline look like?

Physical therapy is a key part of your recovery and typically follows these stages:

• Weeks 1 to 6: Focus is on gentle, passive range-of-motion exercises guided by a therapist to prevent stiffness without stressing the repair.
• Weeks 6 to 12: Active movement is introduced, and you will begin light stretching to restore full motion.
• Months 3 to 6: Strengthening exercises begin, gradually progressing to functional movements and sports-specific training.

Complete healing and return to full activities can take 6 to 9 months.

Q12. What are the instructions for incision care and showering after the procedure?

Keeping your incisions clean and dry is vital:

• Dressings: Keep your initial surgical dressings dry for the first 2-3 days.
• Showering: Once permitted (usually after 3-5 days), you can shower. Cover the incisions with waterproof band-aids. Let soapy water run gently over the shoulder; do not scrub. Pat dry immediately.
• Avoid soaking: Do not submerge your shoulder in baths, pools, or hot tubs until the incisions are fully healed and your doctor approves.

Q13. When is it safe to return to driving, work, and sports activities?

Return timelines vary based on your occupation and activity level:

• Driving: Typically safe after 4 to 6 weeks, once you are out of the sling and no longer taking prescription pain medications.
• Sedentary/Desk work: You may return within 1 to 2 weeks, using your non-surgical hand.
• Heavy manual labor: Usually requires 4 to 6 months of rehabilitation.
• Sports: Light activities can resume around 3 to 4 months, but contact or overhead sports (throwing) usually require 6 months or more.

Q14. What are the potential risks and complications associated with this surgery?

While arthroscopic SLAP repair is safe, potential risks include:

• Shoulder stiffness (frozen shoulder), which is the most common issue.
• Incomplete healing of the labrum or persistent pain.
• Infection (less than 1% risk).
• Nerve injury, resulting in temporary numbness or weakness.
• Reaction to anesthesia.

Strictly following your post-operative instructions and physical therapy plan greatly reduces these risks.

Q15. What are the long-term success rates, and what can I expect for my shoulder recovery?

The long-term success rate for arthroscopic SLAP repair is high, with over 80% to 90% of patients experiencing significant pain reduction, improved shoulder stability, and a return to their previous level of function. Patience is key, as full recovery is a gradual process that takes between 6 and 12 months of consistent rehabilitation and strength building.

We encourage you to write down any specific questions you have and discuss them thoroughly with your surgeon, doctor, or physical therapist. They are your best resource for personalized advice and care.

Disclaimer: This brochure provides general information and is not a substitute for professional medical advice. Always consult your doctor or qualified healthcare provider with any questions you may have regarding your specific medical condition and treatment plan.