Clinical Scenario: Historically, superior labral tears anterior to posterior (SLAP) of the shoulder have been widely viewed as uncommon; however, current literature supports a rise in surgical repair of these lesions. Treatment for SLAP tears in athletes through surgical or conservative methods often produces a low return to play (RTP) rate. However, the most effective treatment to increase RTP rates at the previous level of activity has yet to be determined. Clinical Question: In athletes who have SLAP tears of the shoulder, how do arthroscopic surgery and biceps tenodesis compare with conservative treatments in return to play efficiency? Summary of Key Findings: A thorough literature search returned 204 possible studies; 4 studies met the inclusion criteria and were included. Current evidence supports the use of conservative treatments before surgery is attempted. When considering whether to pursue surgical interventions or continue nonoperatively, conservative treatments produced relatively similar results as surgical interventions; however, overhead athletes showed a lower return to previous play (RTPP) rates than regular athletes. Clinical Bottom Line: There were consistent findings from multiple low-quality studies that indicate there is no clear difference in the use of conservative treatments compared with surgical interventions when comparing RTP rates in physically active athletes. Strength of Recommendation: Grade C evidence exists that conservative treatments and surgical interventions equally minimally improve RTP rates.
Jarratt, Kelly, "The Evaluation of Conservative Treatments and Surgical Interventions on Return to Play Outcomes in Shoulder Labrum Tears in Athletes: A Critically Appraised Topic" (2021). Fall Showcase for Research and Creative Inquiry. 161.