Not All SLAPs Are Created Equal: A Comparison of Patients withPlanned and Incidental SLAP Repair Procedures

Epidemiological studies have shown a progressive increase in the rate of superior labrum anterior-posterior (SLAP)repair surgery after the year 2000. However, it is not clear whether this is due to increased recognition of isolated SLAP tears orincreased SLAP repair performed secondarily during arthroscopy for other purposes.Hypothesis/Purpose. We hypothesized thatboth isolated SLAP repair and secondary SLAP repair increased with time and that patient age influenced the pathway to SLAPdiagnosis and surgery—such that younger patients were more likely to have isolated SLAP repair surgery after being diagnosed inclinic.Study Design. Descriptive epidemiology study.Methods. Data were obtained from the MarketScan database from 2003 to2013. CPT and ICD-9 codes were used to identify SLAP surgery patients and concomitant procedures. *e timing of SLAPdiagnosis relative to surgery was used to determine whether the injury was recognized preoperatively.Results. 64,497 SLAPsurgery patients were included. Preoperative SLAP diagnosis increased from 17.1% in 2003 to 44.6% in 2013. Patients diagnosedpreoperatively were younger and had fewer concomitant procedures. Increasing age and concomitant rotator cuff tear (RCT)repair corresponded to lower odds of preoperative SLAP diagnosis.Discussion. Younger patients were more likely to have theirSLAPteardiagnosedpriortosurgery.*osediagnosedbeforesurgeryhadfewersimultaneousproceduresduringtheiroperations,suggestingthatSLAPrepairwasmorelikelytheprimaryoperation.From2003to2013,SLAPtearswereincreasinglyrecognizedinthe preoperative setting.