Summary

Compared with a cyst decompression and SLAP repair, a cyst decompression with subpectoral biceps tenodesis resulted in equivalent clinical outcomes in the clinical and radiographic outcomes for a SLAP lesion with a concomitant paralabral cyst. The findings of our study suggested the usefulness of biceps tenodesis for management of patients with a poor biceps condition.

Abstract

Background

Superior labrum anterior and posterior (SLAP) lesion with a paralabral cyst is not a common disease, thus, various procedures have been suggested and there has been no optimal choice.

Purpose

The purpose of this study was to compare clinical and radiological results between two procedures: 1 with superior labrum anterior and posterior (SLAP) repair and cyst decompression (RD group) and others with subpectoral biceps tenodesis with cyst decompression. (TD group)

Methods

Arthroscopic surgery for management of a paralabral cyst with a SLAP lesion was performed from January 2009 to January 2023, 42 patients (RD group: 17, TD group: 25), and patients who were available for minimum of 12 months of follow-up were included. The visual analog scale (VAS) pain score; University of California, Los Angeles (UCLA) score; activities of daily living (ADL) score and subjective shoulder value (SSV) were evaluated. Postoperative MRI and manual muscle test (MMT) were performed six months after surgery.

Results

The mean age of patients in the RD group was 40.0 years and that of the TD group was 46.4. (p = 0.014) The mean follow-up period was 48.8 months. Both groups showed significant improvement in the VAS pain score, UCLA score, ADL score, SSV score and MMT after surgery. However, no significant difference was observed between the two groups. All but one patient in the RD group was able to return to work and sports at preoperative levels. This patient was diagnosed as a brachial plexopathy after surgery and showed spontaneous improvement. Sixteen patients (38.1%) underwent follow-up MRI six months after surgery, and there was no recurrence of the ganglion cyst with complete resorption.

Conclusion

Compared with a cyst decompression and SLAP repair, a cyst decompression with subpectoral biceps tenodesis resulted in equivalent clinical outcomes in the clinical and radiographic outcomes for a SLAP lesion with a concomitant paralabral cyst. The findings of our study suggested the usefulness of biceps tenodesis for management of patients with a poor biceps condition.