Biceps tenotomy vs. tenodesis : an ACS-NSQIP analysis of postoperative outcomes and utilization trends

Background: While studies have assessed comparative rates of restoration of shoulder function and alleviation of symptoms, comparative systemic postoperative complication rates between biceps tenotomy and tenodesis have yet to be assessed. The purpose of the present study was to use a national admin...

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Veröffentlicht in:JSES international. - 2020. - 8(2024), 4 vom: 04. Juli, Seite 828-836
1. Verfasser: Siddiq, Bilal S (VerfasserIn)
Weitere Verfasser: Dean, Michael C, Gillinov, Stephen M, Lee, Jonathan S, Dowley, Kieran S, Cherian, Nathan J, Martin, Scott D
Format: Online-Aufsatz
Sprache:English
Veröffentlicht: 2024
Zugriff auf das übergeordnete Werk:JSES international
Schlagworte:Journal Article Healthcare optimization Long head of the biceps NSQIP Perioperative complications Shoulder arthroscopy Tenodesis Tenotomy Utilization trends
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245 1 0 |a Biceps tenotomy vs. tenodesis  |b an ACS-NSQIP analysis of postoperative outcomes and utilization trends 
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520 |a Background: While studies have assessed comparative rates of restoration of shoulder function and alleviation of symptoms, comparative systemic postoperative complication rates between biceps tenotomy and tenodesis have yet to be assessed. The purpose of the present study was to use a national administrative database to perform a comprehensive investigation into 30-day complication rates after biceps tenotomy versus tenodesis, thus providing valuable insights for informed decision-making by clinicians and patients regarding the optimal surgical approach for pathologies of the long head of the biceps tendon 
520 |a Methods: The National Surgical Quality Improvement Program database was queried to analyze postoperative complication rates and metrics associated with biceps tenotomy and tenodesis. Patient data spanning from 2012 to 2021 was extracted, with relevant variables assessed to identify and compare these two surgical approaches. Adjusted and unadjusted analyses were utilized to analyze patient demographics, comorbidities, operative times, lengths of stay, readmissions, adverse events, and yearly surgical volume, along with trends in usage, across cohorts 
520 |a Results: Of 11,527 total patients, 264 (2.29%), 6826 (59.22%), and 4437 (38.49%) underwent tenotomy, tenodesis with open repair, and tenodesis with arthroscopic repair, respectively. Tenotomy operative times ([mean ± SD]: 66.25 ± 44.76 minutes) were shorter than those for open tenodesis (78.83 ± 41.82) and arthroscopic tenodesis (75.98 ± 40.16). Conversely, tenotomy patients had longer hospital days (0.88 ± 4.86 days) relative to open tenodesis (.08 ± 1.55) and arthroscopic tenodesis (.12 ± 2.70). Multivariable logistic regression controlling for demographics and comorbidities demonstrated that patients undergoing tenodesis were less likely to be readmitted (adjusted odds ratio [AOR]: 0.42, 95% confidence interval [CI]: 0.17-0.98, P = .050) or sustain serious adverse events (AOR: 0.27, 95% CI: 0.13-0.57, P < .001), but equally likely to sustain minor adverse events (AOR: 0.87, CI: 0.21-3.68, P = .850), compared with patients undergoing tenotomy. Lastly, comparing utilization rates from 2012 to 2021 revealed a significant decrease in the proportion of tenotomy (from 6.2% to 1.0%) compared to open tenodesis (from 41.0% to 57.3%) and arthroscopic tenodesis (52.8% to 41.64%; P trend = .001) 
520 |a Conclusion: To our knowledge, this is the first large national database study investigating postoperative complication rates between the various surgical treatments for pathologies of the long head of the biceps tendon. Our results suggest that tenodesis yields fewer serious adverse events and lower readmission rates than tenotomy. We also found a shorter operative time for tenotomy. These findings support the increased utilization of tenodesis relative to tenotomy in recent years 
650 4 |a Journal Article 
650 4 |a Healthcare optimization 
650 4 |a Long head of the biceps 
650 4 |a NSQIP 
650 4 |a Perioperative complications 
650 4 |a Shoulder arthroscopy 
650 4 |a Tenodesis 
650 4 |a Tenotomy 
650 4 |a Utilization trends 
700 1 |a Dean, Michael C  |e verfasserin  |4 aut 
700 1 |a Gillinov, Stephen M  |e verfasserin  |4 aut 
700 1 |a Lee, Jonathan S  |e verfasserin  |4 aut 
700 1 |a Dowley, Kieran S  |e verfasserin  |4 aut 
700 1 |a Cherian, Nathan J  |e verfasserin  |4 aut 
700 1 |a Martin, Scott D  |e verfasserin  |4 aut 
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