Biceps Tenodesis Outperforms SLAP Repair in Overhead Athletes

Biceps tenodesis is more cost-effective and yields a higher quality of life than superior labrum anterior to posterior (SLAP) repair for overhead athletes with type 2 superior labrum tears. This conclusion follows a Markov decision-analytic model presented at the Arthroscopy Association of North America and reported by Healio on June 8, 2026.

The research focused specifically on overhead athletes, a group that places significant stress on the shoulder joint. The findings suggest that for those suffering from type 2 superior labrum tears, the surgical approach used to treat the injury significantly impacts both patient outcomes and healthcare spending.

A Markov decision-analytic model was utilized to compare the two primary surgical interventions: biceps tenodesis and SLAP repair. The model indicated that biceps tenodesis provided a superior balance of quality-of-life improvements and reduced costs.

Why is biceps tenodesis preferred over SLAP repair?

The preference for biceps tenodesis in this patient population stems from its performance in cost-effectiveness metrics. While SLAP repair attempts to fix the torn labrum in its original position, biceps tenodesis involves relocating the attachment point of the biceps tendon.

Matthew Frederickson, MD, a resident at the University of California, Davis, detailed the findings during the Arthroscopy Association of North America meeting.

We found that biceps tenodesis is the preferred strategy from a cost-effectiveness standpoint in overhead athletes with type 2 [superior labrum anterior to posterior (SLAP)] tears over SLAP repair. Matthew Frederickson, MD

By prioritizing tenodesis, the model suggests that athletes may experience better functional recovery while reducing the overall financial burden associated with the procedure and subsequent care.

What are the clinical implications for overhead athletes?

Overhead athletes, such as baseball pitchers or volleyball players, are particularly susceptible to type 2 SLAP tears. These injuries occur when the superior labrum is detached from the glenoid, often involving the biceps anchor.

The choice between repair and tenodesis has long been a point of discussion in orthopedic surgery. The data presented on June 8, 2026, provides a quantitative basis for choosing tenodesis, specifically by linking higher quality of life to lower medical costs.

This shift in strategy suggests that attempting to anatomically repair the labrum may not always be the most efficient path to recovery for this specific athlete demographic.

How does the Markov model support these findings?

The use of a Markov decision-analytic model allows researchers to simulate the long-term outcomes of different treatment paths. This method accounts for various health states and the probability of transitioning between them over time.

In this instance, the model compared the longitudinal costs and quality-adjusted life years associated with both biceps tenodesis and SLAP repair. The results consistently favored tenodesis for those with type 2 tears.

These results were presented to peers and specialists at the Arthroscopy Association of North America to help refine surgical decision-making for sports-related shoulder injuries.