The Impact of Workman’s Compensation on Recovery After Biceps Tenodesis

Abstract

The purpose of this study is to compare the postoperative recovery outcomes of after isolated biceps tenodesis in patients with and without workman’s compensation claims. Workman’s compensation (WC) claims have been associated with poor outcomes after a variety of orthopedic surgery procedures, particularly when examining recurrent pain and function. However, the impact of WC on a variety of outcomes after shoulder surgery is not as well understood. Biceps tenodesis is a well-established treatment for isolated biceps or superior labrum pathology. However, the impact of factors, such as workman’s compensation have yet to be examined in depth Using the surgical outcomes system (SOS) database (Arthrex Inc., Naples, FL), we assessed the postoperative recovery outcomes for all patients who had outcomes recorded at least 6 months after isolated biceps tenodesis. The time points analyzed included, preoperative and postoperative (2 weeks, 6 weeks, 3 months, 6 months, 1 year, 2 years). The outcomes analyzed included visual analog score (VAS), American shoulder and elbow score (ASES), VR-12 mental and physical, simple shoulder test (SST), and SANE. Overall, 181 patients with WC claims underwent isolated biceps tenodesis, compared to 1,069 patients without WC claims. There were similar demographics and comorbidities in the two groups, including gender (34% females in WC vs 38% females in non-WC), age (mean 47 years in WC vs. 50 years in non-WC), smokers (15% in WC vs. 10% in non-WC), and diabetes (8% in WC vs. 6% in non-WC). The postoperative recovery curves for VAS, ASES, and SANE are displayed in Figure 1 below. Patients without WC claims had significantly improved VAS, VR-12, ASES, SANE, and SST scores at all times points after 3 months when compared to those with WC claims (p<0.001). However, given many with measures were significantly worse preoperatively in patients with WC claims, we also analyzed the preoperative to postoperative change in all outcomes at each time point. At 1 year when compared to those without WC claims, patients with WC claims had worse VAS (p=0.03), ASES (p=0.007), SANE (p<0.001), and SST (p=0.08) (Figure 2 below). When analyzing the patient’s recovery after isolated biceps tenodesis, workman’s compensation claims lead to significantly worse pain and functional outcomes at every major time point (3, 6, 12, and 24 months). Furthermore, the patients with WC also had worse preoperative to postoperative improvements in most of the outcomes. This information can be used to educate surgeons and patients on postoperative expectations, as well as analyses focused on health economics, value, and policy.