The Effect of Concomitant Biceps Tenodesis on Reoperation Rates After Rotator Cuff Repair: A Review of a Large Private-Payer Database From 2007 to 2014.
OBJECTIVE
To determine if reoperation rates are higher for patients who underwent isolated rotator cuff repair (RCR) than those who underwent RCR with concomitant biceps tenodesis using a large private-payer database.


METHODS
A national insurance database was queried for patients who underwent arthroscopic RCR between the years 2007 and 2014 (PearlDiver, Warsaw, IN). The Current Procedural Terminology (CPT) 29,827 (arthroscopy, shoulder, surgical; with RCR) identified RCR patients who were subdivided into 3 groups-group 1: RCR without biceps tenodesis; group 2: RCR with concomitant arthroscopic biceps tenodesis (CPT 29827 and 29,828); group 3: RCR with concomitant open biceps tenodesis (CPT 29827 and 23,430). Reoperation rates (revision RCR, subsequent biceps surgeries) and complications at 30 days, 90 days, 6 months, and 1 year were analyzed. Multivariate logistic regression was used to compare reoperations and complications between groups. Rotator cuff tear size, whether the biceps was ruptured and whether a biceps tenotomy was performed, was not available.


RESULTS
Group 1: 27,178 patients. Group 2: 4,810 patients. Group 3: 1,493 patients. More patients underwent concomitant arthroscopic than concomitant open tenodesis (P < .001). A total of 2,509 patients underwent a reoperation for RCR or biceps tenodesis within 1 year after RCR. When adjusted for age, sex, and comorbidities, no significant differences in reoperation rates at 30 days or 90 days among the 3 groups, but significantly more patients who had a tenodesis, required a reoperation compared with those who did not have a tenodesis at 6 months and 1 year (both P < .001). Urinary tract infections were more common in patients who did not have a tenodesis, whereas dislocation, nerve injury, and surgical site infection were more common in tenodesis patients.


CONCLUSIONS
Higher reoperation rates at 1 year were seen in patients who had concomitant biceps tenodesis.


METHODS
Level III, case-control database review study.
Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois, U.S.A.. Electronic address: berickso.24@gmail.com.
Brandon J
BJ
Erickson
Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois, U.S.A.
Bryce A
BA
Basques
Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois, U.S.A.
Justin W
JW
Griffin
Hospital for Special Surgery, New York, New York, U.S.A.
Samuel A
SA
Taylor
Hospital for Special Surgery, New York, New York, U.S.A.
Stephen J
SJ
O'Brien
Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois, U.S.A.
Nikhil N
NN
Verma
Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois, U.S.A.
Anthony A
AA
Romeo
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001182:Arthroscopy / Q000009:adverse effects*; D016022:Case-Control Studies; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007345:Insurance Claim Review; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012086:Reoperation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D000070636:Rotator Cuff Injuries / Q000601:surgery*; D013708:Tendon Injuries / Q000601:surgery*; D053656:Tenodesis / Q000009:adverse effects*; D014481:United States; D055815:Young Adult