Prevalence of Rotator Cuff Repairs with and Without Concomitant Subacromial Decompressions Has Not Changed

Abstract

Background

Recent research from the American Board of Orthopaedic Surgery database indicates a decreasing rate of subacromial decompression (SAD) performed with rotator cuff repair (RCR) by younger orthopedic surgeons.

Questions/Purposes

The purpose of this study was to determine the rate of RCR with and without SAD and whether the rate of RCR with SAD decreased over time. Further, we set out to determine if there was significant variation in the rate of RCR with SAD by state.

Methods

Rates of RCR with and without open or arthroscopic SAD from 2010 to 2012 were determined based upon de-identified data from a national health insurance carrier. Data were normalized per 10,000 insured patients for comparative analysis.

Results

Rates of RCR with concomitant SAD were higher than RCR without SAD in each year analyzed. In patients 50 years old and older, this same significant difference was also seen for each year. The rate of RCR with or without SAD did not decrease over the 3-year time period. The rate of RCR performed concomitantly with SAD was significantly higher than RCR performed without SAD in all patient age groups combined. There was wide variation in the rate of RCR with or without concurrent SAD across states.

Conclusion

Disproving our hypothesis, the overall rate of RCR with or without SAD did not decrease over the period from 2010 to 2012. There was wide variation in the rate of RCR by state; however, this variation was not seen in the incidence of SAD performed concomitant with the RCR.

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Correspondence to Daniel D. Buss MD.

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Conflict of Interest

Ned Tervola, MA, ATC; L. Pearce McCarty III, MD; and M. Russell Giveans, PhD, declare that they have no conflicts of interest. Daniel D. Buss, MD, reports that he serves as a member of the UnitedHealthCare Scientific Advisory Board. Steve H. Stern, MD, reports that he is an employee of UnitedHealth Group.

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Informed consent was waived from all patients for being included in this study.

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Level of Evidence: Therapeutic Study: Level IV

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Buss, D.D., Stern, S.H., Tervola, N. et al. Prevalence of Rotator Cuff Repairs with and Without Concomitant Subacromial Decompressions Has Not Changed. HSS Jrnl 14, 123–127 (2018). https://doi.org/10.1007/s11420-017-9594-0

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Keywords

  • subacromial decompression
  • rotator cuff repair
  • variation
  • rate
  • geography
  • age