Similar Outcomes after Cyst Decompression with Biceps Tenodesis Versus Cyst Decompression with Repair of Superior Labrum Anterior to Posterior Lesions in Patients with Paralabral Cysts
Source: PubMed Central Open Access, NCBI / U.S. National Library of Medicine
Background Superior labrum anterior to posterior (SLAP) lesions with paralabral cysts are uncommon. Although various procedures have been suggested, there is no consensus on the optimal choice. The purpose of this study was to compare clinical and radiological results between 2 procedures: SLAP repair with cyst decompression (RD group) and 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 in 42 patients (RD group: 17, TD group: 25), who were available for a minimum 12-month follow-up. 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 magnetic resonance imaging (MRI) and manual muscle testing (MMT) were performed 6 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 years (= 0.014). 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 2 groups. All but 1 patient in the RD group were able to return to work and sports at preoperative levels. This patient was diagnosed with brachial plexopathy after surgery and showed spontaneous improvement. Twenty-five of 42 patients (59.5%) underwent follow-
Abstract
Background Superior labrum anterior to posterior (SLAP) lesions with paralabral cysts are uncommon. Although various procedures have been suggested, there is no consensus on the optimal choice. The purpose of this study was to compare clinical and radiological results between 2 procedures: SLAP repair with cyst decompression (RD group) and 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 in 42 patients (RD group: 17, TD group: 25), who were available for a minimum 12-month follow-up. 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 magnetic resonance imaging (MRI) and manual muscle testing (MMT) were performed 6 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 years (= 0.014). 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 2 groups. All but 1 patient in the RD group were able to return to work and sports at preoperative levels. This patient was diagnosed with brachial plexopathy after surgery and showed spontaneous improvement. Twenty-five of 42 patients (59.5%) underwent follow-up MRI 6 months after surgery, and there was no recurrence of the ganglion cyst with complete resorption. Conclusions Compared with cyst decompression and SLAP repair, cyst decompression combined with subpectoral biceps tenodesis demonstrated no statistically significant differences in clinical and radiographic outcomes in this retrospective cohort of patients with SLAP lesions and concomitant paralabral cysts. The findings of our study suggest that biceps tenodesis may be an effective surgical alternative for patients with compromised biceps integrity.