开放性肱二头肌肌腱固定术和肌腱切断术的术后30天并发症发生率较低。
Open Biceps Tenodesis and Tenotomy Have Low 30-Day Postoperative Complication Rates.
作者信息
Whitaker Sarah, Cole Sarah, Peri Maria, Satalich James, O'Neill Conor, Vap Alexander
机构信息
Virginia Commonwealth University School of Medicine, Richmond, Virginia, U.S.A.
Department of Orthopaedic Surgery, Virginia Commonwealth University Health System, Richmond, Virginia, U.S.A.
出版信息
Arthrosc Sports Med Rehabil. 2024 Mar 21;6(3):100928. doi: 10.1016/j.asmr.2024.100928. eCollection 2024 Jun.
PURPOSE
To compare 30-day postoperative rates of adverse events, particularly infection rates, between open biceps tenodesis and biceps tenotomy.
METHODS
The American College of Surgeons National Surgical Quality Improvement Program was filtered using codes to identify patients undergoing open biceps tenodesis and tenotomy from 2010 to 2021. Patients were divided into cohorts based on procedure type. Propensity score matching was used to account for confounding variables. Statistical analyses were conducted to compare 30-day postoperative outcomes between cohorts, as well as to evaluate secondary risk factors for complications.
RESULTS
Overall, 12,367 patients were included in the study with 11,417 undergoing open biceps tenodesis and 950 undergoing biceps tenotomy. After matching, 1,900 patients were included in the final analysis. The rate of outpatient procedures in the tenodesis cohort was significantly higher than in the tenotomy cohort. Rates of any adverse event (AAE), sepsis, pneumonia, reoperation, and extended length of stay (LOS) were significantly higher in the tenotomy cohort compared with the tenodesis cohort. There was no difference in infection rates or wound dehiscence between the 2 groups. After multivariable analysis, increasing age, longer operative time, and history of bleeding disorders were associated with significantly higher odds of developing AAE.
CONCLUSIONS
In this study, we found that tenotomy and open tenodesis are both safe options for treatment of biceps pathology. The overall rate of developing AAE and the rate of postoperative sepsis were higher in the tenotomy cohort. In addition, rates of postoperative infection and wound dehiscence did not vary between the 2 groups. Small differences were additionally observed in rates of pneumonia, return to the operating room, and extended LOS, and these rates were higher in the tenotomy cohort.
LEVEL OF EVIDENCE
Level III, retrospective comparative study.
目的
比较开放性肱二头肌肌腱固定术和肱二头肌肌腱切断术术后30天不良事件发生率，尤其是感染率。
方法
利用编码对美国外科医师学会国家外科质量改进计划进行筛选，以识别2010年至2021年期间接受开放性肱二头肌肌腱固定术和肌腱切断术的患者。根据手术类型将患者分为不同队列。采用倾向评分匹配法来处理混杂变量。进行统计分析以比较各队列术后30天的结果，并评估并发症的次要危险因素。
结果
总体而言，该研究共纳入12367例患者，其中11417例行开放性肱二头肌肌腱固定术，950例行肱二头肌肌腱切断术。匹配后，1900例患者纳入最终分析。肌腱固定术队列的门诊手术率显著高于肌腱切断术队列。肌腱切断术队列的任何不良事件（AAE）、脓毒症、肺炎、再次手术和延长住院时间（LOS）发生率均显著高于肌腱固定术队列。两组之间的感染率和伤口裂开情况无差异。多变量分析后，年龄增加、手术时间延长和出血性疾病史与发生AAE的几率显著升高相关。
结论
在本研究中，我们发现肌腱切断术和开放性肌腱固定术都是治疗肱二头肌病变的安全选择。肌腱切断术队列中发生AAE的总体发生率和术后脓毒症发生率更高。此外，两组之间术后感染率和伤口裂开率没有差异。在肺炎、返回手术室和延长LOS发生率方面还观察到细微差异，且这些发生率在肌腱切断术队列中更高。
证据级别
III级，回顾性比较研究。
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