gms | German Medical Science

Objectives: Shoulder injuries are on a rising numbers in rock climbers. Over a time frame of 4 years we found 17.2 % of all climbing injuries to be on the shoulder. SLAP lesions (superior labral lesion anterior to posterior) are herebye the most common injury. In our previsous analysis they accounted for 32.5% off all shoulder injuries in climbers. Most of these SLAP injuries require a surgical repair. Nowadays our generall approach is a primary long biceps head tenodesis (PLBT) in SLAP 2 lesions.

Aim of the study is to analyse the general and sport specific outcome of a primary tenodesis in SLAP injuries in overhead athletes.

Methods: 37 overhead sports patients (30 male, 7 female) with SLAP lesions who received a surgical repair including PLBT entered the study. 30 were climbers, 6 swimmers and 1 skittle athlete. 5 patients had a SLAP 1, 19 a SLAP 2, 1 a SLAP 3, 2 a SLAP 4 and 10 a SLAP 5 tear. All received a PLBT between 2008 - 2014. Re-evaluation (standardized questionaire and clinical examination) was performed in average 31 month post surgery (12-70 months). As climbing levels and grades differ among different climbing areas, the ability to climb at the same UIAA metric level +/- 0,33 in redpoint style, in comparison to the hardest pre-injury redpoint climb, was defined as 'preoperative climbing level regained'. The study was approved by the ethical board of the XXX, FRG.

Results and Conclusion: 10 climbers did not regain their initial climbing level yet, 18 did and 2 excelled their initial level. 22 of 30 reached a climbing level inbetween +/- 0.66 UIAA metric grades of their initial capability. In the swimmers 4 regained their prior level, one 2 did not (in one case based on a different injury). The skittle player regained his level. The average Constant Murley Score was 89,4.

Analysing the cause of SLAP injuries there are acute injuries or chronic degenerative tears. The pathology in climbers is chronic. Due to chronic overload in certain climbing positions (inwardly rotated arm position) the long biceps tendon anchor comes under stress. In generall, there are two theories for these chronic SLAP, an internal impingement and a "peel back mechanism". Both these theories apply to various climbing positions.

After known weak outcomes of direct SLAP repair in overhead athletes we started with primary arthrodesis allready 10y ago. In comparison to the literature the present study could again achieve good Constant Murley Scores and a very satisfactionary outcome in the sport specific analysis. Most of the climbers were within a +/- 0.66 UIAA metric grade range of their initial climbing level. This justifies a PLBT in rock climbers.