Superior labral lesions: diagnosis and management.

Objective: To review the pathoanatomy, classification, and etiologies of lesions of the superior labrum and biceps anchor (SLAP lesions) and to discuss the clinical presentation, with emphasis on physical examination findings and current treatment recommendations.

Methods: We searched MEDLINE for English-language articles published from 1985 to 1999 using the key words "superior labral lesion," "SLAP lesion," "labral tear," and "biceps tendon." Additional information was obtained from cross- referencing pertinent articles and personal communications with experts in the field of shoulder arthroscopy.

Results: The clinical presentation of superior labral lesions often includes a history of trauma or repetitive overuse in athletes associated with complaints of pain and clicking or popping in the shoulder. The diagnosis can be difficult, as clinical findings may overlap with those of acromioclavicular or rotator cuff problems and exist concomitantly with glenohumeral instability.

Conclusions: Superior labral lesions are a relatively newly defined cause of shoulder pain and disability. Knowledge about these lesions and a high index of suspicion are essential to identifying this important cause of shoulder pain. Superior labral lesions are usually confirmed and successfully managed arthroscopically.