肩峰成形术发病率的上升。
The rising incidence of acromioplasty.
机构信息
Center for Shoulder, Elbow and Sports Medicine, Department of Orthopaedic Surgery, New York-Presbyterian Medical Center, Columbia University, 622 West 168th Street, PH-1117, New York, NY 10032, USA.
出版信息
J Bone Joint Surg Am. 2010 Aug 4;92(9):1842-50. doi: 10.2106/JBJS.I.01003.
BACKGROUND
Acromioplasty is considered a technically simple procedure but has become controversial with regard to its indications and therapeutic value.
METHODS
Two complementary databases were used to ascertain the frequency of acromioplasty over a recent span of time. In Part A, the New York Statewide Planning and Research Cooperative System (SPARCS) ambulatory surgery database was searched from 1996 to 2006 to identify all ambulatory surgery acromioplasties as well as all orthopaedic ambulatory surgery procedures. In Part B, the American Board of Orthopaedic Surgery (ABOS) database was searched from 1999 to 2008 to identify all arthroscopic acromioplasties as well as all orthopaedic procedures.
RESULTS
Part A revealed that in 1996 there were 5571 acromioplasties in New York State, representing a population incidence of 30.0 per 100,000. In 2006 there were 19,743 acromioplasties, representing a population incidence of 101.9 per 100,000. Over these eleven years, the volume of acromioplasties increased by 254.4%, compared with only a 78.3% increase in the volume of all orthopaedic ambulatory surgery procedures. In 2006, as compared with 1996, patients were 2.4 times more likely to have an acromioplasty compared with all other orthopaedic ambulatory procedures (p < 0.0001). Part B revealed that, in 1999, a mean of 2.6 arthroscopic acromioplasties were reported per candidate for Board certification. In 2008 a mean of 6.3 arthroscopic acromioplasties per candidate were reported. Over these ten years, the mean number of arthroscopic acromioplasties reported increased by 142.3%, compared with only a 13.0% increase in the mean number of all orthopaedic surgery procedures. In 2008, as compared with 1999, candidates were 2.2 times more likely to report an arthroscopic acromioplasty compared with all other orthopaedic procedures (p < 0.0001).
CONCLUSIONS
There has been a substantial increase in the overall volume and the population-based incidence of acromioplasties in recent years on both the state and national levels in the United States. The reasons for this increase have yet to be determined and are likely multifactorial, with patient-based, surgeon-based, and systems-based factors all playing a role.
背景
肩峰成形术被认为是一种技术上简单的手术，但在适应证和治疗价值方面存在争议。
方法
使用两个互补的数据库来确定在最近一段时间内肩峰成形术的频率。在 A 部分中，从 1996 年到 2006 年，搜索纽约州全州规划和研究合作系统（SPARCS）门诊手术数据库，以确定所有门诊手术肩峰成形术以及所有骨科门诊手术程序。在 B 部分中，从 1999 年到 2008 年，搜索美国骨科委员会（ABOS）数据库，以确定所有关节镜下肩峰成形术以及所有骨科手术程序。
结果
A 部分显示，1996 年纽约州有 5571 例肩峰成形术，占每 10 万人中的 30.0 例。2006 年有 19743 例肩峰成形术，占每 10 万人中的 101.9 例。在这十一年中，肩峰成形术的数量增加了 254.4%，而所有骨科门诊手术程序的数量仅增加了 78.3%。2006 年，与 1996 年相比，患者接受肩峰成形术的可能性是接受所有其他骨科门诊手术程序的 2.4 倍（p <0.0001）。B 部分显示，1999 年，每位候选人平均报告了 2.6 例关节镜下肩峰成形术。2008 年，每位候选人平均报告了 6.3 例关节镜下肩峰成形术。在这十年中，报告的关节镜下肩峰成形术数量增加了 142.3%，而所有骨科手术程序的平均数量仅增加了 13.0%。2008 年，与 1999 年相比，候选人报告关节镜下肩峰成形术的可能性是报告所有其他骨科手术的 2.2 倍（p <0.0001）。
结论
近年来，美国州和国家层面的肩峰成形术总体数量和基于人群的发病率都大幅增加。这种增加的原因尚待确定，可能是多因素的，涉及患者、外科医生和系统因素。
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