Kreulen R Timothy, Agarwal Amil R, Nayar Suresh K, Wang Kevin Y, Miller Andrew S, Best Matthew J, Srikumaran Uma
Johns Hopkins Hospital, Baltimore, MD, USA.
George Washington University, Washington, DC, USA.
JSES Int. 2022 Dec 10;7(2):290-295. doi: 10.1016/j.jseint.2022.11.001. eCollection 2023 Mar.
The management of superior labrum anterior to posterior (SLAP) tears typically consists of either repair or biceps tenodesis (BT). While repair is more frequently recommended in younger patients, patients older than 40 years are often treated with BT. The purpose of this study is to determine whether there has been a change in utilization of these procedures over the past decade with respect to patient age as well as compare reoperation rates between the two procedures.
The Pearldiver database was queried to identify BT and SLAP repairs indicated for SLAP tears performed from 2010 to 2019. The primary outcome was utilization rate, stratified by age. A secondary outcome was 2-year shoulder reoperation rates. Trends were reported in terms of compounded annual growth rate. Outcome analysis was conducted using univariate and multivariable analysis.
From 2010 to 2019, SLAP repair was the most common procedure performed for SLAP tears. Regardless of age, BT performed for SLAP tear had a significantly increased utilization rate; whereas, SLAP repair had a significantly decreased utilization rate. SLAP repair was more commonly performed in younger patients compared to BT. Following multivariable analysis, patients who underwent SLAP repair had significantly higher odds (odds ratio (OR): 1.453; 95% confidence interval (CI): 1.26-1.68; < .001) of requiring an arthroscopic reoperation within 2 years when compared to those who underwent BT with no significant difference with respect to 2-year open reoperation.
Although SLAP repair is still more commonly used to treat SLAP tears than BT, especially for younger patients, the utilization of SLAP repair is decreasing while BT is increasing. The increased utilization of BT may be associated with lower rates of shoulder reoperation for problematic SLAP tears.
上盂唇前至后（SLAP）损伤的治疗通常包括修复或肱二头肌固定术（BT）。虽然在年轻患者中更常推荐修复，但40岁以上的患者通常采用BT治疗。本研究的目的是确定在过去十年中，这些手术的使用情况在患者年龄方面是否有变化，并比较两种手术的再次手术率。
查询Pearldiver数据库，以识别2010年至2019年期间因SLAP损伤而进行的BT和SLAP修复。主要结果是利用率，按年龄分层。次要结果是2年的肩部再次手术率。趋势以复合年增长率报告。使用单变量和多变量分析进行结果分析。
从2010年到2019年，SLAP修复是治疗SLAP损伤最常用的手术。无论年龄如何，因SLAP损伤而进行的BT利用率显著增加；而SLAP修复的利用率显著下降。与BT相比，SLAP修复在年轻患者中更常用。经过多变量分析，与接受BT的患者相比，接受SLAP修复的患者在2年内需要进行关节镜再次手术的几率显著更高（优势比（OR）：1.453；95%置信区间（CI）：1.26-1.68；P<0.001），而在2年开放性再次手术方面无显著差异。
虽然SLAP修复仍然比BT更常用于治疗SLAP损伤，尤其是在年轻患者中，但SLAP修复的使用率正在下降，而BT的使用率正在上升。BT使用率的增加可能与有问题的SLAP损伤的肩部再次手术率较低有关。
