Superior Labral Anterior-Posterior Lesions in Rock Climbers—Primary Double Tenodesis?

Abstract

OBJECTIVE: Shoulder problems, especially SLAP (superior labral anterior-posterior) lesions, are frequent in rock climbers. Although various SLAP repair methods demonstrate 75% to 97% good functional outcomes in general population, the results in overhead athletes are inconsistent and the question whether a primary tenodesis is more efficient arises. DESIGN: Prospective cohort study. SETTING: The patients were treated as inpatient surgical patients, and the follow-up was performed after 6 months and 2 years. PATIENTS: Six high-level rock climbers with SLAP lesions and degeneration of the long biceps tendon anchor or additional pulley lesions were surgically treated with primary tenodesis. INTERVENTIONS: Primary tenodesis was performed for SLAP lesions in high-level climbers. MAIN OUTCOME MEASURES: The postoperative outcome was assessed through physical examination after 6 months and 2 years, Constant-Murley score, re-establishment of initial climbing ability level, and self-perception of the function of the shoulder and climbing ability. RESULTS: All climbers regained their initial climbing level after 6 months. The Constant-Murley score (mean, 97.3%) showed an excellent functional outcome. The self-perception of the shoulder function and climbing ability was 96.8% of normal. CONCLUSIONS: The primary biceps tenodesis is proved to be a reliable alternative to arthroscopic SLAP repair in overhead athletes, especially if constant microtrauma persists.