Surgical treatment of long head of biceps pathology: analyzing trends in the United States from 2010 to 2019

Abstract

Background

The long head of the biceps tendon (LHBT) is a common cause of anterior shoulder pain. A symptomatic LHBT is commonly encountered in the setting of a rotator cuff tear. The purpose of this study was to determine trends in the incidence of isolated tenotomy and tenodesis procedures for symptomatic LHBT in the setting of rotator cuff repairs (RCR).

Methods

The MarketScan database was queried from 2010 to 2019 for biceps tenotomy (open) and tenodesis (open and arthroscopic) in the United States. Annual procedure volumes and incidences were calculated using discharge weights and U.S. Census Bureau data, respectively. Further subgroup analysis included age, gender, and region.

Results

Open tenodesis remained the most common procedure in the United States for isolated LHBT management. Its incidence increased by 180% from 2010 to 2019, accounting for 49% of isolated LHBT procedures by 2019. In the setting of RCR, arthroscopic tenodesis was most common, and its incidence grew by 138%. By 2019, arthroscopic tenodesis accounted for 58% of procedures in the setting of RCR, while tenotomy claimed only 2%. The incidence of all procedures increased for the age ≥65 cohort, with a notable 828% increase in the incidence of open tenodesis as an isolated procedure, accounting for 76% of procedures by 2019.

Conclusion

Volumes of procedures aimed to ameliorate LHBT pathology increased from 2010 to 2019. Open tenodesis remained the preferred procedure for isolated LHBT pathology, while arthroscopic tenodesis was preferred in the setting of concomitant RCR. Future research can develop algorithmic approaches to treating biceps pathology.