PDF(Pubmed)
Abstract：
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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).
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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).
UNASSIGNED: 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.
摘要：
■虽然研究评估了肩关节功能恢复和症状缓解的比较率，肱二头肌肌腱切开术和肌腱固定术之间的比较术后并发症发生率尚待评估。本研究的目的是使用国家管理数据库对肱二头肌肌腱切开术和肌腱固定术后30天的并发症发生率进行全面调查。从而为临床医生和患者就肱二头肌长头肌腱病变的最佳手术方法做出明智的决策提供有价值的见解。
■查询了国家外科质量改进计划数据库，以分析与肱二头肌肌腱切开术和肌腱固定术相关的术后并发症发生率和指标。提取了2012年至2021年的患者数据，评估相关变量以识别和比较这两种手术方法。调整和未调整的分析用于分析患者的人口统计学，合并症,手术时间，逗留的长度,再入院,不良事件,和每年的手术量，随着使用趋势，跨队列。
■总共11,527名患者中，264（2.29%），6826（59.22%），和4437（38.49％）进行了肌腱切开术，采用开放式修复的肌腱固定术，和关节镜修复的肌腱固定术，分别。肌腱切开手术时间（[平均值±SD]：66.25±44.76分钟）短于开放肌腱固定术（78.83±41.82）和关节镜下肌腱固定术（75.98±40.16）。相反，与开放性肌腱固定术(.08±1.55)和关节镜下肌腱固定术(.12±2.70)相比,肌腱切开术患者的住院天数(0.88±4.86天)更长.对人口统计学和合并症进行多变量逻辑回归控制表明，接受肌腱固定术的患者不太可能再次入院（调整后的比值比[AOR]：0.42，95％置信区间[CI]：0.17-0.98，P=0.050）或维持严重不良事件（AOR：0.27，95％CI：0.13-0.57，P<.001），但同样可能发生轻微不良事件（AOR：0.87，CI：0.21-3.68，P=.850），与接受肌腱切开术的患者相比。最后,比较2012-2021年的使用率,发现与开放性肌腱固定术(从41.0%到57.3%)和关节镜下肌腱固定术(52.8%到41.64%;P趋势=.001)相比,肌腱切开术的比例显著下降(从6.2%到1.0%).
■据我们所知，这是第一个大型国家数据库研究，调查二头肌长头肌腱病变的各种手术治疗之间的术后并发症发生率。我们的结果表明，肌腱固定术产生的严重不良事件较少，再入院率低于肌腱切开术。我们还发现肌腱切开术的手术时间较短。这些发现支持近年来肌腱固定术相对于肌腱切开术的使用增加。
■查询了国家外科质量改进计划数据库，以分析与肱二头肌肌腱切开术和肌腱固定术相关的术后并发症发生率和指标。提取了2012年至2021年的患者数据，评估相关变量以识别和比较这两种手术方法。调整和未调整的分析用于分析患者的人口统计学，合并症,手术时间，逗留的长度,再入院,不良事件,和每年的手术量，随着使用趋势，跨队列。
■总共11,527名患者中，264（2.29%），6826（59.22%），和4437（38.49％）进行了肌腱切开术，采用开放式修复的肌腱固定术，和关节镜修复的肌腱固定术，分别。肌腱切开手术时间（[平均值±SD]：66.25±44.76分钟）短于开放肌腱固定术（78.83±41.82）和关节镜下肌腱固定术（75.98±40.16）。相反，与开放性肌腱固定术(.08±1.55)和关节镜下肌腱固定术(.12±2.70)相比,肌腱切开术患者的住院天数(0.88±4.86天)更长.对人口统计学和合并症进行多变量逻辑回归控制表明，接受肌腱固定术的患者不太可能再次入院（调整后的比值比[AOR]：0.42，95％置信区间[CI]：0.17-0.98，P=0.050）或维持严重不良事件（AOR：0.27，95％CI：0.13-0.57，P<.001），但同样可能发生轻微不良事件（AOR：0.87，CI：0.21-3.68，P=.850），与接受肌腱切开术的患者相比。最后,比较2012-2021年的使用率,发现与开放性肌腱固定术(从41.0%到57.3%)和关节镜下肌腱固定术(52.8%到41.64%;P趋势=.001)相比,肌腱切开术的比例显著下降(从6.2%到1.0%).
■据我们所知，这是第一个大型国家数据库研究，调查二头肌长头肌腱病变的各种手术治疗之间的术后并发症发生率。我们的结果表明，肌腱固定术产生的严重不良事件较少，再入院率低于肌腱切开术。我们还发现肌腱切开术的手术时间较短。这些发现支持近年来肌腱固定术相对于肌腱切开术的使用增加。
