Increased reoperation rates among patients undergoing shoulder arthroscopy with concomitant biceps tenodesis

Abstract

BackgroundThe 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.MethodsA 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 International Classification of Diseases, Ninth Revision 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.ResultsWe 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]; P < .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]; P < .001).ConclusionReoperation 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.

Costs, Complications, and Reoperations Associated With Primary Arthroscopic Rotator Cuff Repair With or Without Acromioplasty and/or Biceps Tenodesis

“…21 Biceps tenodesis techniques differ by approach (open vs arthroscopic), location (proximal, suprapectoral, subpectoral), and fixation type (soft tissue to soft tissue vs soft tissue to bone). [22][23][24][25][26] Although functional and clinical outcomes following BT with or without RCR repair are favorable, 24,[27][28][29] concerns remain about the cost effectiveness of BT over the long-term. Arthroscopic BT has been shown to have increased costs when compared with open procedures, 30 but few data exist regarding the cost-effectiveness of arthroscopic BT alone or in combination with acro when examining total procedural and postoperative costs.…”

“…Although functional and clinical outcomes following BT with or without RCR repair are favorable, 24 , 27 , 28 , 29 concerns remain about the cost effectiveness of BT over the long-term. Arthroscopic BT has been shown to have increased costs when compared with open procedures, 30 but few data exist regarding the cost-effectiveness of arthroscopic BT alone or in combination with acro when examining total procedural and postoperative costs.…”

While the Incidence of Venous Thromboembolism After Shoulder Arthroscopy Is Low, the Risk Factors Are a Body Mass Index Greater than 30 and Hypertension

“… 23 2014 Japan Single Center 2011 – 2013 4 Case-control study 61 71.4 175 10 (5.714) 1 (0.571) 10 (5.714) Xiao et al. 83 2019 USA PearlDiver 2007 – 2017 3 Non-randomized controlled cohort study NR 53.59 58,907 NR NR 45 (0.076) Yeung et al. 84 2020 USA ABOS 2012 – 2016 4 Case-series 56.27 62.6 1725 2 (0.116) 3 (0.174) 5 (0.29) Rees et al.…”

The Effect of Concomitant Biceps Tenodesis on Revision Surgery Rates After Primary Rotator Cuff Repair

“… 5 There remains a lack of consensus regarding the best treatment option for addressing LHBT-related pain, especially in patients with concomitant rotator cuff pathology. 6 Current treatment options for LHBT-related pain include nonsurgical management, tenotomy, or tenodesis. 7 A comparison between tenotomy and tenodesis has shown mixed results, with similar outcomes reported for both procedures.…”

“… 15 Nonetheless, previous research has shown mixed results. Some studies have shown higher revision surgery rates in patients undergoing RCR with BT compared with patients undergoing RCR without BT, 6 , 15 whereas others have shown no difference in revision surgery rates at all. 16 However, these studies were limited to a 1- to 2-year postoperative period.…”