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肩袖上盂唇损伤:治疗趋势

SLAP Lesions: Trends in Treatment.

作者信息

Erickson Brandon J, Jain Akshay, Abrams Geoffrey D, Nicholson Gregory P, Cole Brian J, Romeo Anthony A, Verma Nikhil N

机构信息

Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois, U.S.A..

Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois, U.S.A.

出版信息

Arthroscopy. 2016 Jun;32(6):976-81. doi: 10.1016/j.arthro.2015.11.044. Epub 2016 Feb 20.

Abstract

PURPOSE

To determine the trends in SLAP repairs over time, including patient age, and percentage of SLAP repairs versus other common shoulder arthroscopic procedures.

METHODS

The records of 4 sports or shoulder/elbow fellowship trained orthopaedic surgeons were used to identify the total number of common shoulder arthroscopic cases performed between 2004 and 2014 using current procedural terminology codes (CPT): 29822, 29823, 29826, 29827, 29806, 29807, 29825, and 29828. The number of SLAP repairs (CPT code 29807) as a combined or isolated procedure were recorded, and the classification of SLAP type was undertaken using operative reports. Patient age was recorded. Linear regression was used to determine statistical significance.

RESULTS

There were 9,765 patients who underwent arthroscopic shoulder procedures using the defined CPT codes between 2004 and 2014 by our 4 orthopaedic surgeons. Of these, 619 underwent a SLAP repair (6.3%); average age 31.2 ± 11.9. The age of patients undergoing SLAP repair significantly decreased over time (P < .001, R(2) = 0.794). Most SLAP repairs were performed on type II SLAP tears (P = .015, R(2) = 0.503). The percentage of SLAP repairs compared with the total number of shoulder arthroscopic surgeries and total number of patients who underwent SLAP repair significantly decreased over time (P < .001, R(2) = 0.832 and P = .002, R(2) = 0.674, respectively). Conversely, the number and percentage of biceps tenodeses are increasing over time (P = .0024 and P = .0099, respectively).

CONCLUSIONS

Over the past 10 years, the total number of biceps tenodeses has increased, whereas the number and relative percentage of SLAP repairs within our practice have decreased. The average age of patients undergoing SLAP repair is decreasing, and most SLAP repairs are performed for type II SLAP tears.

LEVEL OF EVIDENCE

Level IV, therapeutic case series.

摘要

目的

确定随着时间推移,SLAP修复术的发展趋势,包括患者年龄,以及SLAP修复术与其他常见肩关节镜手术相比的占比情况。

方法

利用4名接受过运动医学或肩肘专科培训的骨科医生的记录,通过当前手术操作术语编码(CPT):29822、29823、29826、29827、29806、29807、29825和29828,确定2004年至2014年间进行的常见肩关节镜手术总数。记录作为联合或单独手术的SLAP修复术(CPT编码29807)数量,并根据手术报告对SLAP类型进行分类。记录患者年龄。采用线性回归分析确定统计学意义。

结果

在2004年至2014年间,我们的4名骨科医生使用规定的CPT编码为9765例患者进行了肩关节镜手术。其中,619例接受了SLAP修复术(6.3%);平均年龄31.2±11.9岁。接受SLAP修复术的患者年龄随时间显著下降(P <.001,R² = 0.794)。大多数SLAP修复术针对的是II型SLAP撕裂(P =.015,R² = 0.503)。与肩关节镜手术总数以及接受SLAP修复术的患者总数相比,SLAP修复术的占比随时间显著下降(分别为P <.001,R² = 0.832和P =.002,R² = 0.674)。相反,肱二头肌肌腱固定术的数量和占比随时间增加(分别为P =.0024和P =.0099)。

结论

在过去10年中,肱二头肌肌腱固定术的总数增加,而我们医疗实践中SLAP修复术的数量和相对占比下降。接受SLAP修复术的患者平均年龄在下降,且大多数SLAP修复术针对的是II型SLAP撕裂。

证据水平

IV级,治疗性病例系列。

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