Belk John W, Jones Steven D, Thon Stephen G, Frank Rachel M
Department of Orthopaedics, University of Colorado School of Medicine, Aurora, Colorado, USA.
Orthop J Sports Med. 2020 Dec 29;8(12):2325967120969414. doi: 10.1177/2325967120969414. eCollection 2020 Dec.
Long head of biceps tendon pathology is a well-described source of pain in the anterior adult shoulder. Shoulder arthroscopic surgeons face this condition on a frequent basis because of the increasing aging population. Trends in treatment for this condition have varied over recent decades. An understanding of these trends may help orthopaedic surgeons counsel these patients.
To evaluate trends in treatment selection, patient population, and complications in recent part II examinees of the American Board of Orthopaedic Surgery (ABOS) board examination.
Cross-sectional study.
Using a database maintained by the ABOS, we accessed and analyzed examinee data from 2008 to 2019 to evaluate trends in the following categories: examination year/subspecialty, region, patient age/sex, International Classification of Diseases code, Current Procedural Terminology code, and complications. These data points were analyzed for all board-eligible candidates from 2008 to 2019.
The annual number of proximal biceps tendon (PBT) procedures performed increased significantly from 597 cases in 2008 to 2203 cases in 2019 ( < .001). Incidence of biceps tendon tenotomy significantly decreased between the years 2007 and 2018 ( < .001). Both open and arthroscopic biceps tenodesis significantly increased between 2007 and 2018 ( < .001). Most PBT cases were performed simultaneously with other procedures (17,283/17,861; 96.8%). The most common PBT procedure performed overall was open tenodesis of long tendon of biceps (∼60.8%). Complication rates for PBT procedures reported each year did not significantly change between 2007 and 2018 (7.5% vs 9.7%; = .103).
PBT procedures are being increasingly performed among recently trained orthopaedic surgeons. Proximal biceps tenotomy has significantly declined, whereas proximal biceps tenodesis, open or arthroscopic, has significantly increased, demonstrating a possible shift in the standard of care among new surgeons.
肱二头肌长头肌腱病变是成人肩部前部疼痛的一个常见原因。由于人口老龄化加剧，肩关节镜外科医生经常会遇到这种情况。近几十年来，这种疾病的治疗趋势有所不同。了解这些趋势可能有助于骨科医生为这些患者提供咨询。
评估美国骨科医师委员会（ABOS）第二部分考试近期考生在治疗选择、患者人群和并发症方面的趋势。
横断面研究。
利用ABOS维护的数据库，我们获取并分析了2008年至2019年考生的数据，以评估以下类别的趋势：考试年份/亚专业、地区、患者年龄/性别、国际疾病分类代码、当前手术操作术语代码和并发症。对2008年至2019年所有符合委员会资格的考生的这些数据点进行了分析。
近端肱二头肌肌腱（PBT）手术的年度数量从2008年的597例显著增加到2019年的2203例（P<0.001）。2007年至2018年间，肱二头肌肌腱切断术的发生率显著下降（P<0.001）。2007年至2018年间，开放和关节镜下肱二头肌肌腱固定术均显著增加（P<0.001）。大多数PBT病例是与其他手术同时进行的（17283/17861；96.8%）。总体上最常见的PBT手术是肱二头肌长肌腱开放固定术（约60.8%）。2007年至2018年间，每年报告的PBT手术并发症发生率没有显著变化（7.5%对9.7%；P = 0.103）。
在最近培训的骨科医生中，PBT手术的实施越来越多。近端肱二头肌肌腱切断术显著减少，而开放或关节镜下近端肱二头肌肌腱固定术显著增加，这表明新外科医生的治疗标准可能发生了转变。
