Declining incidence of acromioplasty in Finland

Juha Paloneva, Vesa Lepola, Jaro Karppinen, Jari Ylinen, Ville Äärimaa, Ville M Mattila, Juha Paloneva, Vesa Lepola, Jaro Karppinen, Jari Ylinen, Ville Äärimaa, Ville M Mattila

Abstract

Background and purpose: An increased incidence rate of acromioplasty has been reported; we analyzed data from the Finnish National Hospital Discharge Register.

Patients and methods: During the 14-year study period (1998-2011), 68,877 acromioplasties without rotator cuff repair were performed on subjects aged 18 years or older.

Results: The incidence of acromioplasty increased by 117% from 75 to 163 per 10(5) person years between 1998 and 2007. The highest incidence was observed in 2007, after which the incidence rate decreased by 20% to 131 per 10(5) person years in 2011. The incidence declined even more at non-profit public hospitals from 2007 to 2011. In contrast, it continued to rise at profit-based private orthopedic clinics.

Interpretation: We propose that this change in clinical practice is due to accumulating high-quality scientific evidence that shows no difference in outcome between acromioplasty and non-surgical interventions for rotator cuff disease with subacromial impingement syndrome. However, the exact cause of the declining incidence cannot be defined based solely on a registry study. Interestingly, this change was not observed at private clinics, where the number of operations increased steadily from 2007 to 2011.

Figures

Figure 1.
Figure 1.
Incidence rates of acromioplasty in Finland, by year. Randomized controlled trials showing equal outcomes for operative and nonoperative treatment of stage-II impingement syndrome were reported by (a) Brox et al. (1999), (b) Haahr et al. (2005), (c) Ketola et al. (2005), (d) Haahr Andersen (2006), and (e) Ketola et al. (2009).
Figure 2.
Figure 2.
Incidence rates of acromioplasty in Finland by year, according to patient age.
Figure 3.
Figure 3.
Incidence rates of acromioplasty in Finland by year, in non-profit and profit healthcare organizations.

References

    1. Birkmeyer JD, Reames BN, McCulloch P, Carr AJ, Campbell WB, Wennberg JE. . Lancet. 2013;382(9898):1121–9.
    1. Brox JI, Gjengedal E, Uppheim G, Bohmer AS, Brevik JI, Ljunggren AE, Staff PH. . J Shoulder Elbow Surg. 1999;8(2):102–11.
    1. Chaudhury S, Gwilym SE, Moser J, Carr AJ. . Nat Rev Rheumatol. 2010;6(4):217–26.
    1. Coghlan JA, Buchbinder R, Green S, Johnston RV, Bell SN. . Cochrane Database Syst Rev. 2008. CD005619.
    1. Davis AD, Kakar S, Moros C, Kaye EK, Schepsis AA, Voloshin I. . Am J Sports Med. 2010;38(3):613–8.
    1. Ferlie E, Wood M, Fitzgerald L. . Qual Health Care. 1999;8(2):99–107.
    1. Haahr JP, Andersen JH. . Scand J Rheumatol. 2006;35(3):224–8.
    1. Haahr JP, Ostergaard S, Dalsgaard J, Norup K, Frost P, Lausen S, Holm EA, Andersen JH. . Ann Rheum Dis. 2005;64(5):760–4.
    1. Holmgren T, Bjornsson Hallgren H, Oberg B, Adolfsson L, Johansson K. . BMJ. 2012;344:e787.
    1. Huttunen TT, Kannus P, Pihlajamäki H, Mattila VM. . BMC Musculoskelet Disord. 2014;15(1):98.
    1. Judge A, Murphy RJ, Maxwell R, Arden NK, Carr AJ. . Bone Joint J. 2014;96-B(1):70–4.
    1. Ketola S, Lehtinen J, Westenius H, Arnala I, Nissinen M, Malmivaara A, Rousi T. Olkanivelen kiertäjäkalvosimen hankausoireyhtymän (impingement)leikkaushoidon satunnaistettu vertaileva vaikuttavuustutkimus. Suomen Ortopedia Ja Traumatologia. 2005;28(3):348–50.
    1. Ketola S, Lehtinen J, Arnala I, Nissinen M, Westenius H, Sintonen H, Aronen P, Konttinen YT, Malmivaara A, Rousi T. . J Bone Joint Surg Br. 2009;91(10):1326–34.
    1. Ketola S, Lehtinen J, Rousi T, Nissinen M, Huhtala H, Konttinen YT, Arnala I. . Bone Joint Res. 2013;2(7):132–9.
    1. Kromer TO, de Bie RA, Bastiaenen CH. . J Rehabil Med. 2013;45(5):488–97.
    1. MacDonald P, McRae S, Leiter J, Mascarenhas R, Lapner P. . J Bone Joint Surg Am. 2011;93(21):1953–60.
    1. Mattila VM, Sillanpaa P, Iivonen T, Parkkari J, Kannus P, Pihlajamaki H. . Injury. 2008;39(12):1373–6.
    1. Milano G, Grasso A, Salvatore M, Zarelli D, Deriu L, Fabbriciani C. . Arthroscopy. 2007;23(1):81–8.
    1. Ministry of Social affairs and Health. Uniform criteria for access to non-emergency treatment 2010 2010 Available from : 978-952-00-3100-8.
    1. Mitchell C, Adebajo A, Hay E, Carr A. . BMJ. 2005;331(7525):1124–8.
    1. Neer CS. . Clin Orthop Relat Res. 1983;173:70–7.
    1. Oh LS, Wolf BR, Hall MP, Levy BA, Marx RG. . Clin Orthop Relat Res. 2007;455:52–63.
    1. Papadonikolakis A, McKenna M, Warme W, Martin BI, Matsen FA. . J Bone Joint Surg Am. 2011;93(19):1827–32.
    1. Seitz AL, McClure PW, Finucane S, Boardman ND, 3rd, Michener LA. . 2011;26(1):1–12.
    1. Statistics Finland. Population structure 2014 [cited 2014 Jan 31]. Available from .
    1. Struyf F, Nijs J, Mollekens S, Jeurissen I, Truijen S, Mottram S, Meeusen R. . Clin Rheumatol. 2013;32(1):73–85.
    1. Sund R. . Scand J Public Health. 2012;40(6):505–15.
    1. Vitale MA, Arons RR, Hurwitz S, Ahmad CS, Levine WN. . J Bone Joint Surg Am. 2010;92(9):1842–50.
    1. Ylinen J, Vuorenmaa M, Paloneva J, Kiviranta I, Kautiainen H, Oikari M, Hakkinen A. . Eur J Phys Rehabil Med. 2013;49(4):499–505.
    1. Yu E, Cil A, Harmsen WS, Schleck C, Sperling JW, Cofield RH. . Arthroscopy. 2010;26(9 Suppl):S142–7.

Source: PubMed

Спонсоры и соавторы

Заболевания

Медикаментозные вмешательства

Подписаться