2023 ISAKOS Biennial Congress ePoster
Comparison of Slap Repair and Biceps Tenodesis: A Trends and Outcome Analysis
Tim Kreulen, MD, Baltimore, MD UNITED STATES
Amil Agarwal, BS, Baltimore, MD UNITED STATES
Jacob D Mikula, MD, Baltimore, MD UNITED STATES
Suresh K Nayar, MD, Baltimore UNITED STATES
Andrew Miller, New York, NY UNITED STATES
Matthew J Best, MD, Baltimore, MD UNITED STATES
Uma Srikumaran, MD, MBA, MPH, Columbia, MD UNITED STATES
Johns Hopkins University, Baltimore, MD, UNITED STATES
FDA Status Not Applicable
Summary
Although SLAP repair is still more commonly used to treat SLAP tears than BT, especially for younger patients, the incidence of BT is increasing while that of SLAP repair is decreasing
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Abstract
Introduction
The management of superior labral anterior to posterior (SLAP) tears typically consists of either repair or biceps tenodesis (BT) depending on age, function, and tear morphology. While repair is more frequently recommended in younger patients, patients older than 40 are often treated with BT. The purpose of this study is to determine whether there has been a recent 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.
Methods
The Pearldiver database was queried to identify BT and SLAP repairs indicated for SLAP tears performed from 2010-2019. The primary outcome was utilization rate, stratified by age (18-25, 25-34, 35-44, 45-54, >55). The utilization rate was defined as the number of cases for a procedure divided by the total number surgical cases for SLAP tear for any given year. Trends were reported in terms of compounded annual growth rates (CAGR). A secondary outcome included a comparison of 2-year shoulder reoperation rates. Outcome analysis was conducted using univariate/multivariable analysis.
Results
SLAP repair was the most common surgical modality for SLAP tear. BT performed for SLAP tear had a significantly increased utilization rate from 2010 to 2019 regardless of age; whereas SLAP repair had a significantly decreased utilization rate regardless of age. SLAP repair was more commonly performed in younger patients compared to BT. BT had a much higher increase in utilization in younger patients, whereas SLAP repair had a much lower decrease in utilization in older patients. Following multivariable analysis, patients that underwent SLAP repair had significantly higher odds (OR: 1.453; 95% CI: 1.26-1.68; p<0.001) of requiring an arthroscopic reoperation within 2-years when compared to those that underwent BT.
Conclusion
Although SLAP repair is still more commonly used to treat SLAP tears than BT, especially for younger patients, the incidence of BT is increasing while that of SLAP repair is decreasing. BT may be associated with lower rates of shoulder reoperation for problematic SLAP tears.