Worden Jacob A, Kopriva John M, Gass Henry M, Hussain Zaamin B, Karzon Anthony L, Chopra Krishna N, Gottschalk Michael B, Wagner Eric R
Department of Orthopaedic Surgery, Medical College of Georgia, Augusta, GA, USA.
Department of Orthopaedic Surgery, Emory University School of Medicine, Atlanta, GA, USA.
JSES Rev Rep Tech. 2025 Jan 23;5(2):160-169. doi: 10.1016/j.xrrt.2024.12.013. eCollection 2025 May.
The long head of the biceps tendon (LHBT) is a common cause of anterior shoulder pain. A symptomatic LHBT is commonly encountered in the setting of a rotator cuff tear. The purpose of this study was to determine trends in the incidence of isolated tenotomy and tenodesis procedures for symptomatic LHBT in the setting of rotator cuff repairs (RCR).
The MarketScan database was queried from 2010 to 2019 for biceps tenotomy (open) and tenodesis (open and arthroscopic) in the United States. Annual procedure volumes and incidences were calculated using discharge weights and U.S. Census Bureau data, respectively. Further subgroup analysis included age, gender, and region.
Open tenodesis remained the most common procedure in the United States for isolated LHBT management. Its incidence increased by 180% from 2010 to 2019, accounting for 49% of isolated LHBT procedures by 2019. In the setting of RCR, arthroscopic tenodesis was most common, and its incidence grew by 138%. By 2019, arthroscopic tenodesis accounted for 58% of procedures in the setting of RCR, while tenotomy claimed only 2%. The incidence of all procedures increased for the age ≥65 cohort, with a notable 828% increase in the incidence of open tenodesis as an isolated procedure, accounting for 76% of procedures by 2019.
Volumes of procedures aimed to ameliorate LHBT pathology increased from 2010 to 2019. Open tenodesis remained the preferred procedure for isolated LHBT pathology, while arthroscopic tenodesis was preferred in the setting of concomitant RCR. Future research can develop algorithmic approaches to treating biceps pathology.
肱二头肌长头肌腱（LHBT）是肩部前方疼痛的常见原因。有症状的LHBT在肩袖撕裂的情况下很常见。本研究的目的是确定在肩袖修复（RCR）背景下，针对有症状LHBT进行孤立性肌腱切断术和肌腱固定术的发生率趋势。
查询2010年至2019年美国MarketScan数据库中关于肱二头肌肌腱切断术（开放）和肌腱固定术（开放和关节镜）的信息。分别使用出院权重和美国人口普查局数据计算年度手术量和发生率。进一步的亚组分析包括年龄、性别和地区。
在美国，开放肌腱固定术仍然是治疗孤立性LHBT最常用的手术。其发生率从2010年到2019年增加了180%，到2019年占孤立性LHBT手术的49%。在RCR的情况下，关节镜下肌腱固定术最常见，其发生率增长了138%。到2019年，关节镜下肌腱固定术占RCR情况下手术的58%，而肌腱切断术仅占2%。年龄≥65岁队列的所有手术发生率均有所增加，作为孤立手术的开放肌腱固定术发生率显著增加了828%，到2019年占手术的76%。
2010年至2019年，旨在改善LHBT病理状况的手术量有所增加。开放肌腱固定术仍然是治疗孤立性LHBT病理状况的首选手术，而在伴有RCR的情况下，关节镜下肌腱固定术是首选。未来的研究可以开发治疗肱二头肌病理状况的算法方法。
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