TYPE-II SLAP LESIONS - 3 SUBTYPES AND THEIR RELATIONSHIPS TO SUPERIORINSTABILITY AND ROTATOR CUFF TEARS

One hundred two type II SLAP lesions without associated anterior insta bility, Bankart lesion, or anterior inferior labral pathology were sur gically treated under arthroscopic control, There were three distinct type II SLAP lesions based on anatomic location: anterior (37%), poste rior (31%), and combined anterior and posterior (31%). Preoperatively, the Speed and O'Brien tests were useful in predicting anterior lesion s, whereas the Jobe relocation test was useful in predicting posterior lesions. Rotator cuff tears were present in 31% of patients and were found to be lesion-location specific. In posterior and combined anteri or posterior lesions, a drive-through sign was always present (despite absence of anterior-inferior labral pathology or a Bankart lesion) an d was eliminated by repair of the posterior component of the SLAP lesi on. We conclude that SLAP lesions with a posterior component develop p osterior-superior instability that manifests itself by a secondary ant erior-inferior pseudolaxity (drive-through sign), and that chronic sup erior instability leads to secondary lesion-location-specific rotator cuff tears that begin as partial thickness tears from inside the joint .