Department of Orthopedic Surgery and Sports Medicine, Mayo Clinic, Rochester, MN, USA.
Department of Orthopedic Surgery and Sports Medicine, Mayo Clinic, Rochester, MN, USA.
J Shoulder Elbow Surg. 2019 Apr;28(4):611-616. doi: 10.1016/j.jse.2018.08.046. Epub 2018 Nov 30.
The incidence of posterior shoulder instability (PSI) in the general population is not well defined. This study aimed to define the population-based incidence of PSI and describe trends in incidence and surgery rates.
The study population included 143 patients (16 females, 127 males) diagnosed with new-onset PSI between January 1, 1994, and December 31, 2015. Medical records were reviewed to extract patient data. Age- and sex-specific incidence rates were calculated and adjusted to the 2010 United States population. Poisson regression was performed to examine trends by timeline, sex, and age.
Age- and sex- adjusted annual incidence of PSI was 4.64 per 100,000 person-years, and posterior dislocation was 1.30 per 100,000 person-years. Peak PSI incidence for males and females was at 14 to 19 years (31.82 and 5.23 per 100,000 person-years). PSI incidence was higher in males than females (8.86 vs. 1.07 per 100,000 person-years, P < .001). The 5-year cumulative risk of surgery for patients with PSI was 53.1% between 1996 and 2002, 59.9% between 2003 and 2008, and 87.5% between 2009 and 2015. Patients with PSI between 2009 and 2015 had a significantly increased rate of surgery (hazard ratio, 2.2; 95% confidence interval, 1.4-3.6; P = .001) compared with those between 1996 and 2002.
The age- and sex- adjusted incidence of PSI in the general population was 4.64 per 100,000 person-years. There is a significantly greater incidence of PSI in males than females, with both sexes peaking at 14 to 19 years and incidence rates remaining elevated throughout the third and fourth decades of life. The incidence of PSI remained stable over time; however, the rate of surgical intervention increased significantly, from 53.1% of patients between 1996 and 2002 to 87.5% of patients between 2009 and 2015.
在普通人群中，后肩不稳定（PSI）的发病率尚不清楚。本研究旨在明确PSI 的人群发病率，并描述发病率和手术率的变化趋势。
研究人群包括 1994 年 1 月 1 日至 2015 年 12 月 31 日期间新诊断为首发 PSI 的 143 名患者（16 名女性，127 名男性）。查阅病历以提取患者数据。计算了年龄和性别特定的发病率，并根据 2010 年美国人口进行了调整。采用泊松回归分析时间、性别和年龄的趋势。
年龄和性别调整后的 PSI 年发病率为每 100,000 人年 4.64 例，后脱位为每 100,000 人年 1.30 例。男性和女性 PSI 的发病高峰为 14 至 19 岁（每 100,000 人年 31.82 和 5.23 例）。男性 PSI 发病率高于女性（8.86 比 1.07 每 100,000 人年，P < 0.001）。1996 年至 2002 年，PSI 患者的 5 年累积手术风险为 53.1%，2003 年至 2008 年为 59.9%，2009 年至 2015 年为 87.5%。与 1996 年至 2002 年相比，2009 年至 2015 年 PSI 患者的手术率显著升高（风险比，2.2；95%置信区间，1.4-3.6；P = 0.001）。
普通人群中 PSI 的年龄和性别调整发病率为每 100,000 人年 4.64 例。男性 PSI 的发病率明显高于女性，男女发病率高峰均在 14 至 19 岁，发病率在第三和第四个十年仍保持较高水平。PSI 的发病率随时间保持稳定；然而，手术干预的比率显著增加，从 1996 年至 2002 年的 53.1%患者增加到 2009 年至 2015 年的 87.5%患者。
