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Rates of Revision Surgery and Total Costs for Patients Undergoing SLAP Repair vs. Biceps Tenodesis

      Introduction

      To retrospectively evaluate rates of revision surgery for Superior Labrum Anterior to Posterior (SLAP) repair and biceps tenodesis at 3 year follow-up.

      Methods

      Using the MarketScan Research Databases (Truven Health Analytics), patients who underwent arthroscopic SLAP repair (CPT code 29807) and open or arthroscopic biceps tenodesis (CPT 23430 or 29828) within the encompassed time period (2003-2014), and who remained tracked within the system for at least three contiguous years post-operatively were included. Patients with concomitant rotator cuff repair, or CPT code 29827, were excluded from the study. Rates of repeat shoulder surgery within three years post procedure were evaluated (defined as the occurrence of any of the following CPT codes: 29807, 23430, 29828, 29822, 29823, 29825), as were comparative demographics, total cost of surgery at 6 months, and narcotic usage.

      Results

      25,142 patients (average age 38.3) underwent SLAP repair, of whom 2,891 (11.5%) underwent a repeat shoulder surgery within three years. Female patients and those aged >35 years had a statistically higher rate of revision (12.6% vs. 11.1%, p < 0.001 and 12.1% vs. 10.4%, p < 0.001, respectively), and tended to take more pain medication (p<0.001). 15,173 patients (average age 55.3) underwent biceps tenodesis, of whom 1,631 (10.7%) underwent revision shoulder surgery within three years. Average rate of revision surgery was statistically higher for SLAP repair vs. tenodesis (11.5% vs 10.7%, p<0.001). Average time to revision was 410 days for SLAP repair vs 386 days for biceps tenodesis (p=0.021). Total cost of SLAP repair ($12,826) was slightly lower than costs for biceps tenodesis ($14,942), p <0.001.

      Conclusion

      Overall the rates of revision and cost data for SLAP repair and biceps tenodesis are similar, however SLAP repair is associated with a small but statistically higher rate of revision shoulder surgery within three years, particularly in females older than 35 years.