Surgical Trends in the Treatment of Superior Labrum Anterior and Posterior Lesions of the Shoulder: Analysis of Data From the American Board of Orthopaedic Surgery Certification Examination Database
Background: After failure of nonoperative treatment, repair has long been the primary treatment option for symptomatic superior labrum anterior and posterior (SLAP) lesions of the shoulder. There is growing evidence to support both biceps tenotomy and tenodesis as effective alternative treatments fo...
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| Veröffentlicht in: | The American journal of sports medicine 2014-08, Vol.42 (8), p.1904-1910 |
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| creator | Patterson, Brendan M. Creighton, R. Alexander Spang, Jeffrey T. Roberson, James R. Kamath, Ganesh V. |
| description | Background:
After failure of nonoperative treatment, repair has long been the primary treatment option for symptomatic superior labrum anterior and posterior (SLAP) lesions of the shoulder. There is growing evidence to support both biceps tenotomy and tenodesis as effective alternative treatments for SLAP lesions.
Hypotheses:
For patients with isolated SLAP lesions, the frequency of SLAP repair has decreased, while treatment with biceps tenodesis and tenotomy has increased. Similar trends are expected in patients with SLAP lesions undergoing concomitant rotator cuff repair.
Study Design:
Cohort study; Level of evidence, 3.
Methods:
A query of the American Board of Orthopaedic Surgery part II database was performed from 2002 to 2011. The database was searched for patients with isolated SLAP lesions undergoing SLAP repair, open biceps tenodesis, arthroscopic biceps tenodesis, or biceps tenotomy. The database was then queried a second time for patients undergoing arthroscopic rotator cuff repair with concomitant SLAP repair, biceps tenodesis, or biceps tenotomy.
Results:
From 2002 to 2011, there were 8963 cases reported for the treatment of an isolated SLAP lesion and 1540 cases reported for the treatment of SLAP lesions with concomitant rotator cuff repair. For patients with isolated SLAP lesions, the proportion of SLAP repairs decreased from 69.3% to 44.8% (P < .0001), while biceps tenodesis increased from 1.9% to 18.8% (P < .0001), and biceps tenotomy increased from 0.4% to 1.7% (P = .018). For patients undergoing concomitant rotator cuff repair, SLAP repair decreased from 60.2% to 15.3% (P < .0001), while biceps tenodesis or tenotomy increased from 6.0% to 28.0% (P < .0001). There was a significant difference in the mean age of patients undergoing SLAP repair (37.1 years) versus biceps tenodesis (47.2 years) versus biceps tenotomy (55.7 years) (P < .0001).
Conclusion:
Practice trends for orthopaedic board candidates indicate that the proportion of SLAP repairs has decreased over time, with an increase in biceps tenodesis and tenotomy. Increased patient age correlates with the likelihood of treatment with biceps tenodesis or tenotomy versus SLAP repair. |
| doi_str_mv | 10.1177/0363546514534939 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1705062207</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_0363546514534939</sage_id><sourcerecordid>3398544661</sourcerecordid><originalsourceid>FETCH-LOGICAL-c351t-891a764930a9ad78e0c365f24de11edad21dfd5fef5b509dfd87dec75f9ac66c3</originalsourceid><addsrcrecordid>eNqNkc9LwzAcxYMobk7vnqTgxUs1aZqkOY7hLxgobJ5L2ny7dbTNTJqD_70pnSKC4Cn58v28F14eQpcE3xIixB2mnLKUM5Iymkoqj9CUMJbElHJ2jKbDOh72E3Tm3A5jTATPTtEkSTOJRYanqFh5u6lL1URrC512Ud1F_RaGSfUtdH1kqmjl92BrY6OlKqxvo3nXj7PqdPRq3GFagqtN5wbFYLHaGt9osOfopFKNg4vDOUNvD_frxVO8fHl8XsyXcUkZ6eNMEiV4SIGVVFpkgMuQokpSDYSAVjohutKsgooVDMtwz4SGUrBKqpLzks7Qzei7t-bdg-vztnYlNI3qwHiXE4EZ5kmCxX9QkkgqWBLQ61_oznjbhSD58NUpkyzjgcIjVVrjnIUq39u6VfYjJzgfqsp_VxUkVwdjX7SgvwVf3QQgHgGnNvDj1b8MPwF9w5sF</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1552459586</pqid></control><display><type>article</type><title>Surgical Trends in the Treatment of Superior Labrum Anterior and Posterior Lesions of the Shoulder: Analysis of Data From the American Board of Orthopaedic Surgery Certification Examination Database</title><source>Access via SAGE</source><source>MEDLINE</source><source>Alma/SFX Local Collection</source><creator>Patterson, Brendan M. ; Creighton, R. Alexander ; Spang, Jeffrey T. ; Roberson, James R. ; Kamath, Ganesh V.</creator><creatorcontrib>Patterson, Brendan M. ; Creighton, R. Alexander ; Spang, Jeffrey T. ; Roberson, James R. ; Kamath, Ganesh V.</creatorcontrib><description>Background:
After failure of nonoperative treatment, repair has long been the primary treatment option for symptomatic superior labrum anterior and posterior (SLAP) lesions of the shoulder. There is growing evidence to support both biceps tenotomy and tenodesis as effective alternative treatments for SLAP lesions.
Hypotheses:
For patients with isolated SLAP lesions, the frequency of SLAP repair has decreased, while treatment with biceps tenodesis and tenotomy has increased. Similar trends are expected in patients with SLAP lesions undergoing concomitant rotator cuff repair.
Study Design:
Cohort study; Level of evidence, 3.
Methods:
A query of the American Board of Orthopaedic Surgery part II database was performed from 2002 to 2011. The database was searched for patients with isolated SLAP lesions undergoing SLAP repair, open biceps tenodesis, arthroscopic biceps tenodesis, or biceps tenotomy. The database was then queried a second time for patients undergoing arthroscopic rotator cuff repair with concomitant SLAP repair, biceps tenodesis, or biceps tenotomy.
Results:
From 2002 to 2011, there were 8963 cases reported for the treatment of an isolated SLAP lesion and 1540 cases reported for the treatment of SLAP lesions with concomitant rotator cuff repair. For patients with isolated SLAP lesions, the proportion of SLAP repairs decreased from 69.3% to 44.8% (P < .0001), while biceps tenodesis increased from 1.9% to 18.8% (P < .0001), and biceps tenotomy increased from 0.4% to 1.7% (P = .018). For patients undergoing concomitant rotator cuff repair, SLAP repair decreased from 60.2% to 15.3% (P < .0001), while biceps tenodesis or tenotomy increased from 6.0% to 28.0% (P < .0001). There was a significant difference in the mean age of patients undergoing SLAP repair (37.1 years) versus biceps tenodesis (47.2 years) versus biceps tenotomy (55.7 years) (P < .0001).
Conclusion:
Practice trends for orthopaedic board candidates indicate that the proportion of SLAP repairs has decreased over time, with an increase in biceps tenodesis and tenotomy. Increased patient age correlates with the likelihood of treatment with biceps tenodesis or tenotomy versus SLAP repair.</description><identifier>ISSN: 0363-5465</identifier><identifier>EISSN: 1552-3365</identifier><identifier>DOI: 10.1177/0363546514534939</identifier><identifier>PMID: 24890780</identifier><identifier>CODEN: AJSMDO</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Adult ; Arms ; Arthroplasty - trends ; Arthroscopy ; Cohort Studies ; Databases, Factual ; Female ; Fibrocartilage - injuries ; Fibrocartilage - surgery ; Humans ; Male ; Middle Aged ; Muscle, Skeletal - surgery ; Orthopedics ; Patients ; Shoulder ; Shoulder - surgery ; Shoulder Injuries ; Sports medicine ; Tenodesis - trends ; Tenotomy - trends ; Treatment Outcome ; United States</subject><ispartof>The American journal of sports medicine, 2014-08, Vol.42 (8), p.1904-1910</ispartof><rights>2014 The Author(s)</rights><rights>2014 The Author(s).</rights><rights>Copyright Sage Publications Ltd. Aug 2014</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c351t-891a764930a9ad78e0c365f24de11edad21dfd5fef5b509dfd87dec75f9ac66c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/0363546514534939$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/0363546514534939$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,780,784,21819,27924,27925,43621,43622</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24890780$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Patterson, Brendan M.</creatorcontrib><creatorcontrib>Creighton, R. Alexander</creatorcontrib><creatorcontrib>Spang, Jeffrey T.</creatorcontrib><creatorcontrib>Roberson, James R.</creatorcontrib><creatorcontrib>Kamath, Ganesh V.</creatorcontrib><title>Surgical Trends in the Treatment of Superior Labrum Anterior and Posterior Lesions of the Shoulder: Analysis of Data From the American Board of Orthopaedic Surgery Certification Examination Database</title><title>The American journal of sports medicine</title><addtitle>Am J Sports Med</addtitle><description>Background:
After failure of nonoperative treatment, repair has long been the primary treatment option for symptomatic superior labrum anterior and posterior (SLAP) lesions of the shoulder. There is growing evidence to support both biceps tenotomy and tenodesis as effective alternative treatments for SLAP lesions.
Hypotheses:
For patients with isolated SLAP lesions, the frequency of SLAP repair has decreased, while treatment with biceps tenodesis and tenotomy has increased. Similar trends are expected in patients with SLAP lesions undergoing concomitant rotator cuff repair.
Study Design:
Cohort study; Level of evidence, 3.
Methods:
A query of the American Board of Orthopaedic Surgery part II database was performed from 2002 to 2011. The database was searched for patients with isolated SLAP lesions undergoing SLAP repair, open biceps tenodesis, arthroscopic biceps tenodesis, or biceps tenotomy. The database was then queried a second time for patients undergoing arthroscopic rotator cuff repair with concomitant SLAP repair, biceps tenodesis, or biceps tenotomy.
Results:
From 2002 to 2011, there were 8963 cases reported for the treatment of an isolated SLAP lesion and 1540 cases reported for the treatment of SLAP lesions with concomitant rotator cuff repair. For patients with isolated SLAP lesions, the proportion of SLAP repairs decreased from 69.3% to 44.8% (P < .0001), while biceps tenodesis increased from 1.9% to 18.8% (P < .0001), and biceps tenotomy increased from 0.4% to 1.7% (P = .018). For patients undergoing concomitant rotator cuff repair, SLAP repair decreased from 60.2% to 15.3% (P < .0001), while biceps tenodesis or tenotomy increased from 6.0% to 28.0% (P < .0001). There was a significant difference in the mean age of patients undergoing SLAP repair (37.1 years) versus biceps tenodesis (47.2 years) versus biceps tenotomy (55.7 years) (P < .0001).
Conclusion:
Practice trends for orthopaedic board candidates indicate that the proportion of SLAP repairs has decreased over time, with an increase in biceps tenodesis and tenotomy. Increased patient age correlates with the likelihood of treatment with biceps tenodesis or tenotomy versus SLAP repair.</description><subject>Adult</subject><subject>Arms</subject><subject>Arthroplasty - trends</subject><subject>Arthroscopy</subject><subject>Cohort Studies</subject><subject>Databases, Factual</subject><subject>Female</subject><subject>Fibrocartilage - injuries</subject><subject>Fibrocartilage - surgery</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Muscle, Skeletal - surgery</subject><subject>Orthopedics</subject><subject>Patients</subject><subject>Shoulder</subject><subject>Shoulder - surgery</subject><subject>Shoulder Injuries</subject><subject>Sports medicine</subject><subject>Tenodesis - trends</subject><subject>Tenotomy - trends</subject><subject>Treatment Outcome</subject><subject>United States</subject><issn>0363-5465</issn><issn>1552-3365</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkc9LwzAcxYMobk7vnqTgxUs1aZqkOY7hLxgobJ5L2ny7dbTNTJqD_70pnSKC4Cn58v28F14eQpcE3xIixB2mnLKUM5Iymkoqj9CUMJbElHJ2jKbDOh72E3Tm3A5jTATPTtEkSTOJRYanqFh5u6lL1URrC512Ud1F_RaGSfUtdH1kqmjl92BrY6OlKqxvo3nXj7PqdPRq3GFagqtN5wbFYLHaGt9osOfopFKNg4vDOUNvD_frxVO8fHl8XsyXcUkZ6eNMEiV4SIGVVFpkgMuQokpSDYSAVjohutKsgooVDMtwz4SGUrBKqpLzks7Qzei7t-bdg-vztnYlNI3qwHiXE4EZ5kmCxX9QkkgqWBLQ61_oznjbhSD58NUpkyzjgcIjVVrjnIUq39u6VfYjJzgfqsp_VxUkVwdjX7SgvwVf3QQgHgGnNvDj1b8MPwF9w5sF</recordid><startdate>201408</startdate><enddate>201408</enddate><creator>Patterson, Brendan M.</creator><creator>Creighton, R. Alexander</creator><creator>Spang, Jeffrey T.</creator><creator>Roberson, James R.</creator><creator>Kamath, Ganesh V.</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope></search><sort><creationdate>201408</creationdate><title>Surgical Trends in the Treatment of Superior Labrum Anterior and Posterior Lesions of the Shoulder</title><author>Patterson, Brendan M. ; Creighton, R. Alexander ; Spang, Jeffrey T. ; Roberson, James R. ; Kamath, Ganesh V.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c351t-891a764930a9ad78e0c365f24de11edad21dfd5fef5b509dfd87dec75f9ac66c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adult</topic><topic>Arms</topic><topic>Arthroplasty - trends</topic><topic>Arthroscopy</topic><topic>Cohort Studies</topic><topic>Databases, Factual</topic><topic>Female</topic><topic>Fibrocartilage - injuries</topic><topic>Fibrocartilage - surgery</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Muscle, Skeletal - surgery</topic><topic>Orthopedics</topic><topic>Patients</topic><topic>Shoulder</topic><topic>Shoulder - surgery</topic><topic>Shoulder Injuries</topic><topic>Sports medicine</topic><topic>Tenodesis - trends</topic><topic>Tenotomy - trends</topic><topic>Treatment Outcome</topic><topic>United States</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Patterson, Brendan M.</creatorcontrib><creatorcontrib>Creighton, R. Alexander</creatorcontrib><creatorcontrib>Spang, Jeffrey T.</creatorcontrib><creatorcontrib>Roberson, James R.</creatorcontrib><creatorcontrib>Kamath, Ganesh V.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of sports medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Patterson, Brendan M.</au><au>Creighton, R. Alexander</au><au>Spang, Jeffrey T.</au><au>Roberson, James R.</au><au>Kamath, Ganesh V.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Surgical Trends in the Treatment of Superior Labrum Anterior and Posterior Lesions of the Shoulder: Analysis of Data From the American Board of Orthopaedic Surgery Certification Examination Database</atitle><jtitle>The American journal of sports medicine</jtitle><addtitle>Am J Sports Med</addtitle><date>2014-08</date><risdate>2014</risdate><volume>42</volume><issue>8</issue><spage>1904</spage><epage>1910</epage><pages>1904-1910</pages><issn>0363-5465</issn><eissn>1552-3365</eissn><coden>AJSMDO</coden><abstract>Background:
After failure of nonoperative treatment, repair has long been the primary treatment option for symptomatic superior labrum anterior and posterior (SLAP) lesions of the shoulder. There is growing evidence to support both biceps tenotomy and tenodesis as effective alternative treatments for SLAP lesions.
Hypotheses:
For patients with isolated SLAP lesions, the frequency of SLAP repair has decreased, while treatment with biceps tenodesis and tenotomy has increased. Similar trends are expected in patients with SLAP lesions undergoing concomitant rotator cuff repair.
Study Design:
Cohort study; Level of evidence, 3.
Methods:
A query of the American Board of Orthopaedic Surgery part II database was performed from 2002 to 2011. The database was searched for patients with isolated SLAP lesions undergoing SLAP repair, open biceps tenodesis, arthroscopic biceps tenodesis, or biceps tenotomy. The database was then queried a second time for patients undergoing arthroscopic rotator cuff repair with concomitant SLAP repair, biceps tenodesis, or biceps tenotomy.
Results:
From 2002 to 2011, there were 8963 cases reported for the treatment of an isolated SLAP lesion and 1540 cases reported for the treatment of SLAP lesions with concomitant rotator cuff repair. For patients with isolated SLAP lesions, the proportion of SLAP repairs decreased from 69.3% to 44.8% (P < .0001), while biceps tenodesis increased from 1.9% to 18.8% (P < .0001), and biceps tenotomy increased from 0.4% to 1.7% (P = .018). For patients undergoing concomitant rotator cuff repair, SLAP repair decreased from 60.2% to 15.3% (P < .0001), while biceps tenodesis or tenotomy increased from 6.0% to 28.0% (P < .0001). There was a significant difference in the mean age of patients undergoing SLAP repair (37.1 years) versus biceps tenodesis (47.2 years) versus biceps tenotomy (55.7 years) (P < .0001).
Conclusion:
Practice trends for orthopaedic board candidates indicate that the proportion of SLAP repairs has decreased over time, with an increase in biceps tenodesis and tenotomy. Increased patient age correlates with the likelihood of treatment with biceps tenodesis or tenotomy versus SLAP repair.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>24890780</pmid><doi>10.1177/0363546514534939</doi><tpages>7</tpages></addata></record> |
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| ispartof | The American journal of sports medicine, 2014-08, Vol.42 (8), p.1904-1910 |
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| source | Access via SAGE; MEDLINE; Alma/SFX Local Collection |
| subjects | Adult Arms Arthroplasty - trends Arthroscopy Cohort Studies Databases, Factual Female Fibrocartilage - injuries Fibrocartilage - surgery Humans Male Middle Aged Muscle, Skeletal - surgery Orthopedics Patients Shoulder Shoulder - surgery Shoulder Injuries Sports medicine Tenodesis - trends Tenotomy - trends Treatment Outcome United States |
| title | Surgical Trends in the Treatment of Superior Labrum Anterior and Posterior Lesions of the Shoulder: Analysis of Data From the American Board of Orthopaedic Surgery Certification Examination Database |
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