Sustained functional improvement and return to activity following arthroscopic superior labrum anterior to posterior repair: A 5-year retrospective study

Objectives: Superior labrum anterior to posterior (SLAP) lesions are a common cause of shoulder pain and dysfunction, particularly in young,active individuals and overhead athletes. Arthroscopic repair with suture anchors is the preferred treatment for symptomatic lesions, but outcomes can vary across age groups and SLAP types. This study aimed to evaluate long-term clinical and functional outcomes following arthroscopic SLAP repair and to identify factors associated with failure, complications, and return to activity. Materials and Methods: We retrospectively reviewed 109 patients who underwent isolated arthroscopic SLAP repair (Type II–IV) between 2014 and 2020 at a tertiary care center, with a minimum follow-up of 5 years. Exclusion criteria included Type I SLAP tears, prior shoulder surgery, arthritis, or concomitant procedures. Functional outcomes were measured using the American Shoulder and Elbow Surgeons (ASES), Visual Analog Scale (VAS), simple shoulder test (SST), Constant–Murley (CM) score, quick disabilities of the arm, shoulder, and hand (QuickDASH), and shoulder range of motion (forward flexion and external rotation). Subgroup analyses were performed based on age (<40 vs. ≥40 years) and SLAP type. Results: The mean age at surgery was 34.8 ± 9.1 years; 75.2% were male. Type II SLAP lesions were most common (64.2%). At 5 years, significant improvements were observed in all outcome measures: ASES (54.3–89.4), VAS (6.7–1.2), SST (4.2–10.6), CM (52.6–89.2), QuickDASH (41.5–9.3), forward flexion (141.2°–172.5°), and external rotation (47.5°–62.1°) (all p < 0.001). Return to pre-injury activity was achieved in 89%. The complication rate was low (3.7% stiffness, no revisions). Conclusions: Arthroscopic SLAP repair provides excellent long-term outcomes with sustained functional improvement, pain relief, and high return-to-activity rates, regardless of age or SLAP subtype.