OBJECTIVES

Shoulder tendinosis refers to degeneration of the tendons’ collagen in response to chronic overuse. This study aims to understand the patient characteristics and current treatment patterns in tendinosis patients in the US.

METHODS

: Adult (age≥18 years) suspected tendinosis patients from January 2013- June 2017 with at least 12-months of continuous enrollment prior (baseline period) to and following (study period) the index date were identified retrospectively from the IBM Watson Health MarketScan® Commercial healthcare claims database using ICD-9/10-CM codes. Patients with claim for tendinosis, rotator cuff tear diagnosis or repair in the baseline period were excluded. Descriptive analysis of patient demographics, clinical characteristics and treatment patterns was reported.

RESULTS

: 101,365 patients were retained in the final analysis. Mean age was 54.7 (±13.7) years, 55% were females and 87.5% were based in the urban areas. During the baseline period, average Deyo-Charlson comorbidity index was 0.6 (± 1.2), hypertension (36%) and diabetes (15%). Within 12-month of diagnosis, 97% of the patients received conservative treatment (physical therapy and/or pain medications). 76.8% patients had a claim for physiotherapy visit. Percentage of patients with opioid and non-opioid medication jumped to 50% and 41% respectively, compared to 41% and 37% during the baseline period. 2.2% patients received debridement surgery, 5.5% had subacromial decompression and 7.4% had received both. 8.3% patients had an arthroscopic repair surgery within one-year of tendinosis diagnosis (69% hospital outpatient, 27% Ambulatory Surgical Centers). Mean time to surgery was 71 (±75.3) days. 5% of these surgical patients had a repeat surgery during the study time-frame.

CONCLUSIONS

: This study provides an insight into the real-world treatment patterns in tendinosis patients. Considerable proportion of these patients end up receiving surgical repair within one year of tendinosis diagnosis possibly indicating disease progression. Further research in understanding the evidence-based outcomes with the current treatment options is recommended.