Avinesh Agarwalla1, Anirudh K Gowd1, Joseph N Liu2, Richard N Puzzitiello1, Brian J Cole1, Anthony A Romeo1, Nikhil N Verma1, Brian Forsythe3. 1. Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois, U.S.A. 2. Department of Orthopaedic Surgery, Loma Linda University Medical Center, Loma Linda, California, U.S.A. 3. Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois, U.S.A.. Electronic address: brian.forsythe@rushortho.com.
Abstract
PURPOSE: To determine when patients return to work after biceps tenodesis stratified by the preinjury level of work-intensity and to identify predictive measures of return to work. METHODS: Patients undergoing biceps tenodesis between 2014 and 2017 were reviewed. Patients receiving concomitant rotator cuff repair or arthroplasty, revision biceps tenodesis, or unemployment before the procedure were excluded. Patient-acceptable symptom state (PASS), substantial clinical benefit, and minimal clinically important difference were calculated for the American Shoulder Elbow Society (ASES) score, subjective Constant-Murley score (CMS), and Single Assessment Numerical Evaluation (SANE) using the anchor-based and distribution-based approach. Preoperative outcome scores were analyzed to determine their predictive power of return to work using receiver operator curve area under the curve (AUC) analysis. Multivariate logistical analysis assessed predictive variables of return to work. RESULTS: Seventy-nine percent of patients were able to return to work without permanent restrictions at an average of 5.4 ± 2.8 months after biceps tenodesis. Return to work status for sedentary, light, moderate, and heavy duties were 100%, 85%, 71%, and 69%, respectively. Return to work was associated with achieving PASS for the ASES and SANE questionnaires (P = .006, .003, respectively) but not for the CMS (P = .768). On multivariate analysis, there were no preoperative or intraoperative variables that were predictive of return to work in full capacity. The preoperative Short Form-12 mental component score (>59.4, AUC = 71.2%) was predictive of returning to work. CONCLUSIONS: After biceps tenodesis, most patients were able to return to work at an average of 5.4 ± 2.8 months. Furthermore, there were no demographic or intraoperative variables that were predictive of return to work. Work intensity was not correlated with an increased duration of return to work. Achieving PASS on the ASES and SANE questionnaires was predictive of return to work. LEVEL OF EVIDENCE: Level IV, case series.
PURPOSE: To determine when patients return to work after biceps tenodesis stratified by the preinjury level of work-intensity and to identify predictive measures of return to work. METHODS:Patients undergoing biceps tenodesis between 2014 and 2017 were reviewed. Patients receiving concomitant rotator cuff repair or arthroplasty, revision biceps tenodesis, or unemployment before the procedure were excluded. Patient-acceptable symptom state (PASS), substantial clinical benefit, and minimal clinically important difference were calculated for the American Shoulder Elbow Society (ASES) score, subjective Constant-Murley score (CMS), and Single Assessment Numerical Evaluation (SANE) using the anchor-based and distribution-based approach. Preoperative outcome scores were analyzed to determine their predictive power of return to work using receiver operator curve area under the curve (AUC) analysis. Multivariate logistical analysis assessed predictive variables of return to work. RESULTS: Seventy-nine percent of patients were able to return to work without permanent restrictions at an average of 5.4 ± 2.8 months after biceps tenodesis. Return to work status for sedentary, light, moderate, and heavy duties were 100%, 85%, 71%, and 69%, respectively. Return to work was associated with achieving PASS for the ASES and SANE questionnaires (P = .006, .003, respectively) but not for the CMS (P = .768). On multivariate analysis, there were no preoperative or intraoperative variables that were predictive of return to work in full capacity. The preoperative Short Form-12 mental component score (>59.4, AUC = 71.2%) was predictive of returning to work. CONCLUSIONS: After biceps tenodesis, most patients were able to return to work at an average of 5.4 ± 2.8 months. Furthermore, there were no demographic or intraoperative variables that were predictive of return to work. Work intensity was not correlated with an increased duration of return to work. Achieving PASS on the ASES and SANE questionnaires was predictive of return to work. LEVEL OF EVIDENCE: Level IV, case series.
Authors: Brandon C Cabarcas; Alexander Beletsky; Joseph Liu; Anirudh K Gowd; Brandon J Manderle; Matthew Cohn; Nikhil N Verma Journal: Arthrosc Sports Med Rehabil Date: 2021-05-29
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