Demographic Trends in Arthroscopic and Open Biceps Tenodesis in New York State

OBJECTIVES: Tenodesis of the long head of the biceps is one of many options to reduce pain caused by proximal long head insertional tendinopathy, tendon instability, or part of a superior labrum anterior-posterior lesion. This technique can be performed either as an open or arthroscopic procedure. The purpose of this study is to compare the relative incidence and demographics of patients who underwent either an arthroscopy or open biceps tenodesis procedure in New York State from 2002-2010. METHODS: Retrospective review of patients who underwent open or arthroscopic biceps tenodesis surgery were identified from the New York State Statewide Planning and Research Commission (SPARCS) ambulatory surgery database, which includes all outpatient surgeries performed at hospitals, outpatient surgical centers, and rural clinics in New York State. Cases of open and arthroscopic biceps tenodesis were identified by unique Current Procedural Terminology codes (23430, 29828). Data from 2002 to 2010 were available for open procedures and from 2008 to 2010 for arthroscopic procedures. Chi-square test and student’s t-test were used to analyze the data. Variables measured included incidence, age, gender, race, ethnicity, type of operating facility, and primary payor. RESULTS: From 2002 to 2010 the incidence of biceps tenodesis rose over 600%. From 2008 to 2010 there were 2672 open biceps tenodesis procedures and 3289 arthroscopic biceps tenodesis procedures performed in New York State. The arthroscopic group contained significantly more women (33%) than the open group (25%, P<.0001). The average age arthroscopic patients was slightly higher (55.33 years) than that of open patients (54.45 years, P<.01). There was a significantly greater proportion of African- American patients in the arthroscopic group. Patients undergoing arthroscopic surgery were more likely to be treated at a hospital as opposed to a free standing clinic. The most common primary payor for open cases was worker’s compensation at 22% of all cases. Of arthroscopic patients, 18% listed worker’s compensation as the primary payor. Medicare patients accounted for 16% of open cases and 19% of arthroscopic patients (P<.001). CONCLUSION: Incidence of biceps tenodesis surgery has increased steadily from 2002 to 2010. There were 23% more arthroscopic procedures performed in 2010 than there were in 2008. Arthroscopic patients are more likely to be older, female, and African American. Arthroscopic biceps tenodeis, which require additional skill and training, were more likely to be performed in a hospital setting.