AANA/SOMOS Enduring Shoulder Program 2024-32 y/o Female Infantry with a SLAP lesion

Video Transcription

Video Summary

The debate focused on optimal management of a 32-year-old female infantry soldier with a Type 2 SLAP lesion. Dr. Mary Mulcahy argued strongly for non-operative treatment, citing the military’s high incidence of such injuries and evidence showing successful outcomes—especially with rigorous rehabilitation emphasizing strengthening, neuromuscular control, and stretching. Studies demonstrate that many athletes and military personnel return to duty without surgery if they complete dedicated rehab programs.<br /><br />Conversely, Dr. Jennifer Smith advocated for prompt surgical intervention, particularly in traumatic SLAP lesions in active military members, highlighting higher rates (~80-90%) of return to duty and improved function with early surgery, especially biceps tenodesis. She emphasized that delaying surgery beyond six months can increase pain and stiffness, and noted tenodesis often yields better outcomes than SLAP repair in older or non-throwing patients.<br /><br />The discussion underscored patient-specific factors including injury mechanism, age, activity level, and shoulder stability to guide treatment choice, balancing risks and the desire for rapid return to duty. Surgical techniques and nuances of SLAP repair versus biceps tenodesis were also detailed.

Asset Caption

Anything But Surgery (Mary K. Mulcahey, M.D., FAANA) vs. Repair or Tenodesis (Jennifer Smith, M.D.)
Discussion, moderated by Jeanne C. Patzkowski, M.D., FAANA
Technique Video: SLAP Repair/Tenodesis (Travis J. Dekker, M.D., FAANA)

Keywords

Type 2 SLAP lesion

non-operative treatment

surgical intervention

biceps tenodesis

military personnel shoulder injury

rehabilitation protocols