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2022 AOSSM Annual Meeting Recordings with CME
Update On Performance And Return To Sport After Bi ...
Update On Performance And Return To Sport After Biceps Tenodesis In Professional Baseball Players
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Video Transcription
So, thank you guys for the opportunity to present. Disclosures are not particularly relevant to this talk. So we know biceps pathology, especially bicep tendonitis, slap tears, is really common among overhead athletes. There's a couple surgical treatments for this. Sometimes it involves a superior labor repair, sometimes it involves a bicep tenodesis, sometimes you can do both. And we don't really know what the ideal treatment in this overhead athletic population is. In the general population, we know this much better, but in the overhead athletes, it's very hard to understand what the proper treatment for patients with superior labral tears and biceps tendonitis is. We did a study back in 2017 looking at Major League Baseball players that had had biceps tenodesis done. And you can see here, there were 17 players that we were included, and most of them were pitchers, 71%. The return to sport rate overall was about 35%, and the position players got back much better than the pitchers. The position players got back at about 80%, pitchers at 17%. When they got back, they did okay, but basically this study showed that this is not a great operation for pitchers. So this was five years ago, so we have five more years of data, so we thought we'd look at this again. So basically our purpose was to look at the return to sport rate and performance upon return to sport in professional baseball players who underwent a bicep tenodesis. Secondarily, we were comparing performance between players who had a bicep tenodesis to some match controls. We basically thought there wouldn't be any difference because we were hoping that maybe our techniques have gotten better over the last five years. We took all professional baseball players between 2014 and 2019 that had a bicep tenodesis that were within the Major League Baseball Hits database. We looked at the operative reports, looked at method of fixation, tenodesis location, any concomitant procedures that they had. We looked at pre- and post-operative level playwrights. We wanted to know if they got back to the minors or the majors depending on where they started and if they advanced, if they were in the minor leagues, and we wanted to have a minimum of two-year follow-up for these players because we know that it can take quite some time for these guys to get back to the same level of sport, and we deemed them to have returned to sport if they got back to playing in any game at their respective level. So if you take a look here, we had 24 players that were eligible to be included. Seven of them didn't have two-years follow-up, so they got excluded. Three had a concomitant rotator cuff repair, so we took them out as well because we know that a concomitant rotator cuff repair is a very different operation than just dealing with the biceps in an overhead athlete. So we had 14 players, 12 pitchers, and two position players that were included. Most of these, almost 80%, were open subpectral biceps tenodesis. That was the technique that most people were using, and from a positioning perspective, some were lateral and some were beach chair, and sometimes that was dictated by what the concomitant procedure that they had done was. This is just to give you an idea of how the biceps tenodesis were performed. So you can see the majority of these were being done with a cortical button. Some people were using searcher anchors versus interference screws, about a quarter, 25% each, and some used drill holes. And then again, you can see the concomitant procedure. So in the last session, we heard about superior labral tears that have some posterior extension, that kind of type VIII slab repair. So a lot of these had a labral repair or labral debridement involved with them, and most of the time, that labral repair was in that posterior superior quadrant. So if you look at the 14 players that we included, about 86% got back to playing. So 50% were able to get back to the same or higher level, which means 50% either got back to a lower level or didn't get back at all. So not as bad as before, but still not great results. When we look at the pitchers specifically, 100% of them got back to playing, but only 50% got back to the same level. So again, something very important to counsel your patients on, that they'll get back to their sport, but they may not get back to the same level afterwards. And the average time to get back was about 245 days. However, if they did get back to playing, they did fine. So you can see here from this chart, basically that there were no significant differences between the controls and the cases on their performance once they did get back. Limitations wise, we didn't include rotator cuff repair in this. This is a very different patient population, so you really can't compare the two. And certainly this is only professional baseball players, so it's hard to generalize this necessarily to the regular population that a lot of us take care of. So in conclusion, you can hear open subpectral tenodesis, most common technique that we use in our overhead professional baseball players. 86% got back to playing, but only 50% were able to get back to the same level of play following a biceps tenodesis. But if they did get back successfully, they did not see a significant decline in their performance afterwards. Thank you.
Video Summary
The video discusses the success of biceps tenodesis surgery in professional baseball players. The study looks at the return to sport rate and performance in players who underwent the surgery, comparing them to match controls. The findings show that 86% of players were able to return to playing, but only 50% were able to return to the same level of play. The average time to return was 245 days. However, once players returned, their performance was not significantly different from the control group. The study concludes that while the surgery can help players get back to playing, there is no guarantee of returning to the same level of performance.
Asset Caption
Brandon Erickson, MD
Keywords
biceps tenodesis surgery
professional baseball players
return to sport rate
performance
match controls
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