Rates and Risk Factors for Revision Open and Arthroscopic Proximal Biceps Tenodesis

Abstract

Background:Biceps tenodesis may be performed for symptomatic tendinopathy or tearing of the long head of the biceps tendon. Biceps tenodesis is also commonly performed as an adjunctive procedure. However, the indications and prevalence of biceps tenodesis have expanded.Purpose:To establish the incidence and risk factors for revision biceps tenodesis.Study Design:Case-control study; Level of evidence, 2.Methods:The PearlDiver database of Humana patient data was queried for patients undergoing arthroscopic or open biceps tenodesis (Current Procedural Terminology [CPT] 29828 and CPT 23430, respectively) from 2008 through the first quarter of 2017. Patients without a CPT laterality modifier were excluded from analysis. Revision biceps tenodesis was defined as patients who underwent subsequent ipsilateral open or arthroscopic biceps tenodesis. The financial impact of revision biceps tenodesis was also calculated. Multivariate binomial logistic regression was performed to identify risk factors for revision biceps tenodesis, such as patient demographics as well as concomitant procedures and diagnoses. Odds ratios (ORs) and 95% CIs were calculated, and all statistical comparisons with P < .05 were considered significant.Results:There were 15,257 patients who underwent biceps tenodesis. Of these, 9274 patients (60.8%) underwent arthroscopic biceps tenodesis, while 5983 (39.2%) underwent open biceps tenodesis. A total of 171 patients (1.8%) and 111 patients (1.9%) required revision biceps tenodesis after arthroscopic and open biceps tenodesis, respectively (P = .5). Male sex (OR, 1.38 [95% CI, 1.04-1.85]; P = .02) was the only independent risk factor for revision biceps tenodesis after the index open biceps tenodesis. After arthroscopic biceps tenodesis, age >45 years (OR, 0.58 [95% CI, 0.39-0.89]; P = .01) and concomitant rotator cuff tear (OR, 0.58 [95% CI, 0.47-0.71]; P < .001) were independent protective factors for revision biceps tenodesis. The total cost of revision biceps tenodesis after open and arthroscopic biceps tenodesis was US$3427.95 and US$2174.33 per patient, respectively.Conclusion:There was no significant difference in the revision rate between arthroscopic and open biceps tenodesis. Risk factors for revision surgery included male sex for open biceps tenodesis, while age >45 years and rotator cuff tears were protective factors for arthroscopic biceps tenodesis.

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

“…54 Surgical options include biceps tenotomy or tenodesis; however, considerable debate remains regarding the optimal surgical strategy. 19,30,55,56 Both strategies provide strong clinical outcomes, however, tenotomy has less associated surgical morbidity and tenodesis may provide better maintenance of supination strength. 56 In the context of rotator cuff repairs, biceps tenotomy or tenodesis may further relieve pain and increase shoulder function.…”

“…[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.…”

The Elongation of Biceps Muscle Tendon Unit After Rerouting of the Long Head of Biceps Tendon as Superior Capsular Augmentation: A Quantitative Measurement

“…Prior studies have suggested that the transverse humeral ligament is a distinct structure covering the intertubercular groove, which is composed of the fibers of the subscapularis tendon, with contributions from the supraspinatus tendon and the coracohumeral ligament. 24 , 25 , 26 , 27 There may be concern about the risk of subscapularis tendon damage after transverse humeral ligament release. However, this procedure has been widely used in LHBT tenodesis with excellent clinical outcomes.…”

“…However, this procedure has been widely used in LHBT tenodesis with excellent clinical outcomes. 27 , 28 …”

Small‑incision open distal subpectoral vs. arthroscopic proximal biceps tenodesis for biceps long head tendon lesions with repair of rotator cuff tears

“…Lesions of the long head of the biceps tendon (LHBT) are among the most common causes of shoulder disorders and pain (1,2). LHBT lesions alone are relatively rare; they are mostly associated with other lesions of the shoulder joint, particularly rotator cuff (RC) injury (1,(3)(4)(5)(6)(7)(8). The normal physiological function of the LHBT depends on the role of the block system, which is mainly composed of supraspinatus (SSP), coracohumeral ligament, superior glenohumeral ligament and subscapularis (SSC) (9).…”