开放式肱二头肌腱膜切除术和腱膜切开术的术后 30 天并发症发生率较低

Q3 Medicine Arthroscopy Sports Medicine and Rehabilitation Pub Date : 2024-06-01 DOI:10.1016/j.asmr.2024.100928

Sarah Whitaker B.A. , Sarah Cole B.A. , Maria Peri B.S. , James Satalich M.D. , Conor O’Neill M.D. , Alexander Vap M.D.

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摘要

目的比较开放式肱二头肌腱膜切除术和肱二头肌腱膜切开术的术后 30 天不良事件发生率，尤其是感染率。方法使用当前手术术语代码对美国外科医生学会国家外科质量改进计划进行筛选，以确定 2010 年至 2021 年期间接受开放式肱二头肌腱膜切除术和腱膜切开术的患者。根据手术类型将患者分为不同组群。采用倾向评分匹配来考虑混杂变量。研究人员进行了统计分析，以比较不同组别患者的术后 30 天预后，并评估并发症的次要风险因素。结果研究共纳入了 12367 例患者，其中 11417 例接受了开放式肱二头肌腱膜切除术，950 例接受了肱二头肌腱膜切开术。经过配对后，有1900名患者被纳入最终分析。腱鞘切除术组的门诊手术率明显高于腱鞘切开术组。与腱膜切开术队列相比，腱膜切开术队列的任何不良事件（AAE）、败血症、肺炎、再次手术和延长住院时间（LOS）的发生率明显更高。两组患者的感染率和伤口开裂率没有差异。结论在这项研究中，我们发现腱切开术和开放性腱鞘切除术都是治疗肱二头肌病变的安全选择。在腱切开术组中，发生 AAE 的总比率和术后败血症的比率较高。此外，两组患者的术后感染率和伤口开裂率没有差异。此外，在肺炎发生率、返回手术室率和延长住院时间方面也观察到了微小差异，而这些发生率在腱切开术组别中更高。

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Open Biceps Tenodesis and Tenotomy Have Low 30-Day Postoperative Complication Rates

Purpose

To compare 30-day postoperative rates of adverse events, particularly infection rates, between open biceps tenodesis and biceps tenotomy.

Methods

The American College of Surgeons National Surgical Quality Improvement Program was filtered using Current Procedural Terminology codes to identify patients undergoing open biceps tenodesis and tenotomy from 2010 to 2021. Patients were divided into cohorts based on procedure type. Propensity score matching was used to account for confounding variables. Statistical analyses were conducted to compare 30-day postoperative outcomes between cohorts, as well as to evaluate secondary risk factors for complications.

Results

Overall, 12,367 patients were included in the study with 11,417 undergoing open biceps tenodesis and 950 undergoing biceps tenotomy. After matching, 1,900 patients were included in the final analysis. The rate of outpatient procedures in the tenodesis cohort was significantly higher than in the tenotomy cohort. Rates of any adverse event (AAE), sepsis, pneumonia, reoperation, and extended length of stay (LOS) were significantly higher in the tenotomy cohort compared with the tenodesis cohort. There was no difference in infection rates or wound dehiscence between the 2 groups. After multivariable analysis, increasing age, longer operative time, and history of bleeding disorders were associated with significantly higher odds of developing AAE.

Conclusions

In this study, we found that tenotomy and open tenodesis are both safe options for treatment of biceps pathology. The overall rate of developing AAE and the rate of postoperative sepsis were higher in the tenotomy cohort. In addition, rates of postoperative infection and wound dehiscence did not vary between the 2 groups. Small differences were additionally observed in rates of pneumonia, return to the operating room, and extended LOS, and these rates were higher in the tenotomy cohort.