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SLAP Repair (Shoulder Labrum)

A SLAP repair reattaches or trims the superior labrum of the shoulder — the cartilage at the top of the socket where the biceps tendon inserts. SLAP stands for Superior Labrum Anterior to Posterior. These tears are most common in overhead athletes: baseball pitchers, swimmers, volleyball players. They also happen from a fall onto an outstretched arm.

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SLAP Repair (Shoulder Labrum) surgery - orthopaedic procedure overview and what to expect

Who Needs SLAP Repair (Shoulder Labrum)?

SLAP repair is typically for patients under 40 with type II tears causing pain, catching, or loss of throwing velocity that haven't improved with 3-6 months of physical therapy. Patients over 40 often do better with biceps tenodesis, which moves the biceps attachment rather than repairing the labrum itself. Healing rates for the superior labrum drop sharply with age, and surgeon judgment on this trade-off matters a lot.

What to Expect

1
MRI arthrogram to identify the tear type and extent
2
Surgery takes 45-90 minutes under general anesthesia
3
Arthroscopic approach through 2-3 small incisions
4
Suture anchors reattach the superior labrum to the glenoid rim
5
Arm in a sling for 4-6 weeks with strict activity restrictions
6
Outpatient procedure — home same day

Recovery Timeline

Weeks 1-6

Sling immobilization. No active shoulder use. Passive range-of-motion exercises only.

Weeks 6-12

Active motion begins. Physical therapy focused on shoulder blade control and rotator cuff.

Months 3-4

Progressive strengthening. Overhead motions introduced.

Months 4-6

Interval throwing program begins for overhead athletes.

Months 6-9

Return to full throwing and sport for most athletes.

Risks & Complications

  • Failure to heal (higher failure rates than Bankart repair — 20-30% in some studies)
  • Stiffness
  • Continued pain or catching
  • Anchor failure
  • Infection (less than 1%)

Frequently Asked Questions

How is a SLAP tear different from a Bankart tear?

Both are labral tears, just in different spots. A Bankart tear is at the front of the socket — it causes instability and dislocations. A SLAP tear is at the top, where the biceps attaches, causing pain and velocity loss with overhead motion. The operations are similar, but the patient populations and outcomes are quite different.

Should I have SLAP repair or biceps tenodesis?

Age is the main variable. Under 35-40 and still throwing competitively, repair is usually preferred. Over 40, biceps tenodesis tends to produce better, more consistent results, since the superior labrum heals poorly as you get older. Your surgeon will weigh your age, throwing goals, and the MRI findings.

How long until a pitcher can throw after SLAP repair?

Getting back to full pitching takes 9-12 months — longer than most shoulder procedures. The interval throwing program starts around month 4-5. Rushing through it is the most common reason repairs fail. Most high-level pitchers take a full year before they're really competing again.

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Estimated Cost

$15,000 - $35,000 (before insurance). Covered by most insurance plans when conservative treatment has failed.

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Related Specialty

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This information is for educational purposes only. Costs are estimates and vary by location, surgeon, and insurance. Always consult a qualified healthcare provider.