Increased Reoperation Rates Among Patients Undergoing Shoulder Arthroscopy with Concomitant Biceps Tenodesis

Overview

Journal JSES Open Access

Publisher Elsevier

Date 2020 Jan 1

PMID 31891037

Citations 6

Authors

Michelle Xiao

Geoffrey D Abrams

Affiliations

Soon will be listed here.

Abstract

Background: The purpose of this study was to determine whether patients undergoing any shoulder arthroscopic procedure with concomitant biceps tenodesis have higher reoperation and complication rates vs. patients undergoing shoulder arthroscopy without concomitant biceps tenodesis.

Methods: A large database was queried for patients undergoing shoulder arthroscopy, identified by Current Procedural Terminology code. Only records indicating the laterality of the procedure were included. Patients were divided into 3 cohorts: arthroscopic shoulder surgery without concomitant biceps tenodesis (group 1), surgery with arthroscopic biceps tenodesis (group 2), and surgery with open biceps tenodesis (group 3). Reoperations on the same shoulder, as well as medical or surgical complications (by code) during the 30-day postoperative period, were determined. Multivariate logistic regression was used to control for differences in age, sex, and Charlson Comorbidity Index between groups.

Results: We identified 62,461 patients (54.3% male patients) in the database who underwent shoulder arthroscopy, with 51,773 patients in group 1, 7134 patients in group 2, and 3554 patients in group 3. Overall, 3134 patients (5.0%) underwent a shoulder arthroscopy reoperation. With adjustment for age, sex, and Charlson Comorbidity Index, the biceps intervention groups demonstrated a significantly higher overall reoperation rate (odds ratio, 1.3 [95% confidence interval, 1.2-1.5]; < .001). Patients undergoing biceps tenodesis had a lower adjusted overall 30-day complication rate vs. those not undergoing tenodesis (odds ratio, 0.82 [95% confidence interval, 0.79-0.86]; < .001).

Conclusion: Reoperation rates were significantly higher in patients undergoing shoulder arthroscopy with biceps tenodesis than in patients undergoing shoulder arthroscopy without biceps tenodesis. Both the arthroscopic and open tenodesis groups had significantly lower complication rates.

Citing Articles

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References

Slenker N, Lawson K, Ciccotti M, Dodson C, Cohen S . Biceps tenotomy versus tenodesis: clinical outcomes. Arthroscopy. 2012; 28(4):576-82. DOI: 10.1016/j.arthro.2011.10.017. View

Provencher M, LeClere L, Romeo A . Subpectoral biceps tenodesis. Sports Med Arthrosc Rev. 2008; 16(3):170-6. DOI: 10.1097/JSA.0b013e3181824edf. View

Friedman J, Fitzpatrick J, Rylander L, Bennett C, Vidal A, McCarty E . Biceps Tenotomy Versus Tenodesis in Active Patients Younger Than 55 Years: Is There a Difference in Strength and Outcomes?. Orthop J Sports Med. 2015; 3(2):2325967115570848. PMC: 4555607. DOI: 10.1177/2325967115570848. View

Erickson B, Basques B, Griffin J, Taylor S, OBrien S, Verma N . The Effect of Concomitant Biceps Tenodesis on Reoperation Rates After Rotator Cuff Repair: A Review of a Large Private-Payer Database From 2007 to 2014. Arthroscopy. 2017; 33(7):1301-1307.e1. DOI: 10.1016/j.arthro.2017.01.030. View

Manske R, Prohaska D . Diagnosis and management of adhesive capsulitis. Curr Rev Musculoskelet Med. 2009; 1(3-4):180-9. PMC: 2682415. DOI: 10.1007/s12178-008-9031-6. View

Dickens J, Kilcoyne K, Tintle S, Giuliani J, Schaefer R, Rue J . Subpectoral biceps tenodesis: an anatomic study and evaluation of at-risk structures. Am J Sports Med. 2012; 40(10):2337-41. DOI: 10.1177/0363546512457654. View

Jarrett C, McClelland Jr W, Xerogeanes J . Minimally invasive proximal biceps tenodesis: an anatomical study for optimal placement and safe surgical technique. J Shoulder Elbow Surg. 2010; 20(3):477-80. DOI: 10.1016/j.jse.2010.08.002. View

Bergenudd H, Lindgarde F, Nilsson B, Petersson C . Shoulder pain in middle age. A study of prevalence and relation to occupational work load and psychosocial factors. Clin Orthop Relat Res. 1988; (231):234-8. View

Nho S, Strauss E, Lenart B, Provencher M, Mazzocca A, Verma N . Long head of the biceps tendinopathy: diagnosis and management. J Am Acad Orthop Surg. 2010; 18(11):645-56. DOI: 10.5435/00124635-201011000-00002. View

10.

Castricini R, Familiari F, De Gori M, Riccelli D, De Benedetto M, Orlando N . Tenodesis is not superior to tenotomy in the treatment of the long head of biceps tendon lesions. Knee Surg Sports Traumatol Arthrosc. 2017; 26(1):169-175. DOI: 10.1007/s00167-017-4609-4. View

11.

Kerschbaum M, Maziak N, Scheuermann M, Scheibel M . [Arthroscopic tenodesis or tenotomy of the long head of the biceps tendon in preselected patients : Does it make a difference?]. Orthopade. 2016; 46(3):215-221. DOI: 10.1007/s00132-016-3358-2. View

12.

Cancienne J, Brockmeier S, Carson E, Werner B . Risk Factors for Infection After Shoulder Arthroscopy in a Large Medicare Population. Am J Sports Med. 2018; 46(4):809-814. DOI: 10.1177/0363546517749212. View

13.

Creech M, Yeung M, Denkers M, Simunovic N, Athwal G, Ayeni O . Surgical indications for long head biceps tenodesis: a systematic review. Knee Surg Sports Traumatol Arthrosc. 2014; 24(7):2156-66. DOI: 10.1007/s00167-014-3383-9. View

14.

Ahmad C, ElAttrache N . Arthroscopic biceps tenodesis. Orthop Clin North Am. 2004; 34(4):499-506. DOI: 10.1016/s0030-5898(03)00093-2. View

15.

Mitchell C, Adebajo A, Hay E, Carr A . Shoulder pain: diagnosis and management in primary care. BMJ. 2005; 331(7525):1124-8. PMC: 1283277. DOI: 10.1136/bmj.331.7525.1124. View

16.

Ge H, Zhang Q, Sun Y, Li J, Sun L, Cheng B . Tenotomy or tenodesis for the long head of biceps lesions in shoulders: a systematic review and meta-analysis. PLoS One. 2015; 10(3):e0121286. PMC: 4364971. DOI: 10.1371/journal.pone.0121286. View

17.

Berlemann U, Bayley I . Tenodesis of the long head of biceps brachii in the painful shoulder: improving results in the long term. J Shoulder Elbow Surg. 1995; 4(6):429-35. DOI: 10.1016/s1058-2746(05)80034-5. View

18.

Johannsen A, Macalena J, Carson E, Tompkins M . Anatomic and radiographic comparison of arthroscopic suprapectoral and open subpectoral biceps tenodesis sites. Am J Sports Med. 2013; 41(12):2919-24. DOI: 10.1177/0363546513503812. View

19.

Gombera M, Kahlenberg C, Nair R, Saltzman M, Terry M . All-arthroscopic suprapectoral versus open subpectoral tenodesis of the long head of the biceps brachii. Am J Sports Med. 2015; 43(5):1077-83. DOI: 10.1177/0363546515570024. View

20.

Lutton D, Gruson K, Harrison A, Gladstone J, Flatow E . Where to tenodese the biceps: proximal or distal?. Clin Orthop Relat Res. 2010; 469(4):1050-5. PMC: 3048262. DOI: 10.1007/s11999-010-1691-z. View