Comparison of Postoperative Pain Following Two Shoulder Procedures in Active Individuals with Shoulder Labral Injury
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Presenter(s)
John, Marino, Yu-Ling
Abstract
Comparison of Postoperative Pain Following Two Shoulder Procedures in Active Individuals with Shoulder Labral Injury
John Dao, Marino Maeda, Yu Ling Zeng
Clinical Scenario
Superior Labrum from Anterior to Posterior (SLAP) repair is the standard treatment for isolated type II SLAP lesions in physically active individuals. However, biceps tenodesis (BT) has emerged as a promising alternative for pain reduction. The purpose of this review is to compare follow-up outcomes by evaluating Visual Analog Scale (VAS) scores between patients who underwent SLAP repair and those who underwent BT.
Focused Clinical Question
Is BT associated with lower VAS scores at follow-up when compared with SLAP repair in physically active individuals with type II SLAP lesions?
Search Strategy
A search of Academic Search Premier, PubMed, the Cochrane Library, and ScienceDirect identified peer-reviewed human studies published in English between 2005 and 2026. Key terms included SLAP lesion, operation, repair, tenodesis, labrum, pain, and VAS. Studies were included if participants were physically active individuals (i.e. athletes, workers, and military soldiers) diagnosed with isolated type II SLAP lesions who underwent SLAP repair or BT and had pain assessed using VAS. Studies were excluded for concomitant shoulder pathology, history of shoulder surgery, or a non-active population.
Evidence Quality Assessment
Evidence quality was assessed using the Oxford Levels of Evidence and the PEDro scale. All studies were classified as Oxford Level 3 due to non-randomized cohort or retrospective designs. PEDro scores ranged from 3/10 to 6/10, reflecting low to moderate quality, largely due to lack of randomization, allocation of concealment, and blinding.
Results and Summary of Search
Seven articles met the criteria. Two studies reported statistically significant lower VAS scores following BT (1.3 ± 1.9 and 1.5 ± 0.5) compared to the SLAP repair group (1.8 ± 0.4 and 2.6 ± 2.5, P < .05). Four studies found no statistically significant differences in pain levels between the two groups (p > .05). One study reported lower VAS scores in the BT group (0.8 ± 0.8) compared to the SLAP repair group (1.7 ± 1.2) when compared to a control group (0.3 ± 0.3). Six studies reported significant reductions in pain levels in both groups following surgery (p < .05). Current evidence suggests that BT is equivalent to or slightly more favorable than SLAP repair for physically active individuals with isolated type II SLAP lesions.
Clinical Bottom Line
BT shows comparable pain reduction to SLAP repair in four of the seven studies with significantly lower VAS scores in two. However, given the overall methodological limitations and a Strength of Recommendation Taxonomy (SORT) rating of B, current evidence supports BT as a favorable yet not definitively superior intervention for follow-up pain reduction.
Implications
BT demonstrates comparable, and in some cases more favorable, intervention outcomes in pain levels during follow‑up. Future reviews should evaluate health outcomes beyond pain at follow-up to empirically determine which intervention successfully returns a patient back to full function and activity. Consistency in inclusion criteria should be considered to maintain homogeneity, improve comparability, and preserve internal validity.
College
College of Nursing & Health Sciences
Department
Health, Exercise & Rehabilitative Sciences
Campus
Winona
First Advisor/Mentor
Nora Kraemer
Second Advisor/Mentor
Blaine Birtzer
Presentation Type
Oral Presentation
Format of Presentation or Performance
Pre-Recorded Video
Comparison of Postoperative Pain Following Two Shoulder Procedures in Active Individuals with Shoulder Labral Injury
Comparison of Postoperative Pain Following Two Shoulder Procedures in Active Individuals with Shoulder Labral Injury
John Dao, Marino Maeda, Yu Ling Zeng
Clinical Scenario
Superior Labrum from Anterior to Posterior (SLAP) repair is the standard treatment for isolated type II SLAP lesions in physically active individuals. However, biceps tenodesis (BT) has emerged as a promising alternative for pain reduction. The purpose of this review is to compare follow-up outcomes by evaluating Visual Analog Scale (VAS) scores between patients who underwent SLAP repair and those who underwent BT.
Focused Clinical Question
Is BT associated with lower VAS scores at follow-up when compared with SLAP repair in physically active individuals with type II SLAP lesions?
Search Strategy
A search of Academic Search Premier, PubMed, the Cochrane Library, and ScienceDirect identified peer-reviewed human studies published in English between 2005 and 2026. Key terms included SLAP lesion, operation, repair, tenodesis, labrum, pain, and VAS. Studies were included if participants were physically active individuals (i.e. athletes, workers, and military soldiers) diagnosed with isolated type II SLAP lesions who underwent SLAP repair or BT and had pain assessed using VAS. Studies were excluded for concomitant shoulder pathology, history of shoulder surgery, or a non-active population.
Evidence Quality Assessment
Evidence quality was assessed using the Oxford Levels of Evidence and the PEDro scale. All studies were classified as Oxford Level 3 due to non-randomized cohort or retrospective designs. PEDro scores ranged from 3/10 to 6/10, reflecting low to moderate quality, largely due to lack of randomization, allocation of concealment, and blinding.
Results and Summary of Search
Seven articles met the criteria. Two studies reported statistically significant lower VAS scores following BT (1.3 ± 1.9 and 1.5 ± 0.5) compared to the SLAP repair group (1.8 ± 0.4 and 2.6 ± 2.5, P < .05). Four studies found no statistically significant differences in pain levels between the two groups (p > .05). One study reported lower VAS scores in the BT group (0.8 ± 0.8) compared to the SLAP repair group (1.7 ± 1.2) when compared to a control group (0.3 ± 0.3). Six studies reported significant reductions in pain levels in both groups following surgery (p < .05). Current evidence suggests that BT is equivalent to or slightly more favorable than SLAP repair for physically active individuals with isolated type II SLAP lesions.
Clinical Bottom Line
BT shows comparable pain reduction to SLAP repair in four of the seven studies with significantly lower VAS scores in two. However, given the overall methodological limitations and a Strength of Recommendation Taxonomy (SORT) rating of B, current evidence supports BT as a favorable yet not definitively superior intervention for follow-up pain reduction.
Implications
BT demonstrates comparable, and in some cases more favorable, intervention outcomes in pain levels during follow‑up. Future reviews should evaluate health outcomes beyond pain at follow-up to empirically determine which intervention successfully returns a patient back to full function and activity. Consistency in inclusion criteria should be considered to maintain homogeneity, improve comparability, and preserve internal validity.
