Study reveals shifting trends in the surgical treatment of SLAP lesions

Source : Healio

A review of information from the American Board of Orthopaedic Surgery part II database indicates that the rate of SLAP repairs performed for both cases of isolated SLAP lesions and those undergoing concomitant rotator cuff repair has decreased, while the rates of biceps tenodesis and tenotomy for these cases have increased.

“Practice trends for orthopedic board candidates indicate that the proportion of SLAP repairs has decreased over time, with an increase in biceps tenodesis and tenotomy,” Brendan M. Patterson, MD, MPH, and his colleagues wrote in their study. “Increased patient age correlates with the likelihood of treatment with biceps tenodesis or tenotomy versus SLAP repair.”

Using the database, the investigators identified 8,963 cases treated for isolated SLAP lesions and 1,540 cases that underwent concomitant rotator cuff repair and treatment for SLAP lesions between 2002 and 2011. Mean patient age was 40.7 years.

Researchers reviewed surgical logs for the following procedures: SLAP repair, open or arthroscopic biceps tenodesis, biceps tenotomy, and arthroscopic rotator cuff repair with concomitant SLAP repair.

Patterson and colleagues found the proportion of SLAP repairs decreased from 69.3% to 44.8% for patients with isolated SLAP lesions. The proportion of biceps tenodesis for these cases increased from 1.9% to 18.8% and biceps tenotomy went from 0.4% to 1.7%. Similarly, the investigators found the proportion of SLAP repair decreased in cases undergoing concomitant rotator cuff repair (from 60.2% to 15.3%).

The proportion of biceps tenodesis or tenotomy for these cases increased from 6.0% to 28.0%. A subanalysis of biceps tenodesis showed that open procedures increased from 1.9% to 9.5% during the total study period, and arthroscopic biceps tenodesis increased in from 0.2% to 9.3% from 2007 to 2011.

Overall, investigators discovered a significant difference in the mean age of patients who had SLAP repair (37.1 years) compared with those who had biceps tenodesis (47.2 years) and biceps tenotomy (55.7 years).

Disclosure: This study was paid for by the University of North Carolina at Chapel Hill, Department of Orthopaedic Surgery, Sports Medicine Research Fund.

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