a Department of Orthopedic Surgery , University of Groningen, University Medical Center Groningen ;
b Department of Orthopedic Surgery and Traumatology , Deventer Hospital , Deventer , the Netherlands.
Acta Orthop. 2019 Jun;90(3):191-195. doi: 10.1080/17453674.2019.1593641. Epub 2019 Apr 1.
Background and purpose - The multidisciplinary Clinical Practice Guideline for diagnosis and treatment of subacromial pain syndrome (SAPS) was created in 2012 by the Dutch Orthopedic Association. In brief, it stated that SAPS should preferably be treated nonoperatively. We evaluated the effect of the implementation of the guideline on the number of shoulder surgeries for SAPS in the Netherlands (17 million inhabitants). Patients and methods - An observational study was conducted with the use of aggregated data from the national database of the Dutch Health Authority from 2012 to 2016. Information was collected on patients referred to and seen at orthopedic departments. Data from the following Diagnoses Related Groupings were analyzed: 1450 (tendinitis supraspinatus) and 1460 (rotator cuff tear). Results - In 2016 fewer patients were diagnosed with tendinitis supraspinatus than in 2012-a decrease from 49,491 to 44,662 (10%). Of the patients diagnosed with tendinitis, 14% were treated surgically in 2012; this number dropped to 9% by 2016. More patients with a rotator cuff tear were diagnosed in 2016 than in 2012, an increase from 17,793 to 23,389 (32%), fewer were treated surgically: 30% in 2012, compared with 25% in 2016. Interpretation - After introducing the multidisciplinary Clinical Practice Guideline "Diagnosis and treatment of subacromial pain syndrome," a decrease in shoulder surgeries for related diagnoses was observed in the Netherlands. The introduction and dissemination of this guideline seems to have contributed to the implementation of more appropriate health care and prevention of unnecessary surgeries.
背景与目的-荷兰骨科协会于 2012 年制定了多学科临床实践指南，用于诊断和治疗肩峰下疼痛综合征（SAPS）。简而言之，该指南主张 SAPS 最好采用非手术治疗。我们评估了该指南的实施对荷兰 SAPS 肩部手术数量的影响（1700 万居民）。患者与方法-使用荷兰卫生署国家数据库的汇总数据进行了一项观察性研究，时间为 2012 年至 2016 年。收集了转诊至骨科就诊的患者信息。分析了以下诊断相关分组的数据：1450（冈上肌腱炎）和 1460（肩袖撕裂）。结果-2016 年，被诊断为冈上肌腱炎的患者比 2012 年少-从 49491 例降至 44662 例（10%）。在被诊断为冈上肌腱炎的患者中，2012 年有 14%接受了手术治疗；到 2016 年，这一比例降至 9%。2016 年被诊断为肩袖撕裂的患者比 2012 年多，从 17793 例增至 23389 例（32%），接受手术治疗的患者更少：2012 年为 30%，2016 年为 25%。解读-引入多学科临床实践指南“肩峰下疼痛综合征的诊断与治疗”后，荷兰与相关诊断相关的肩部手术数量有所减少。该指南的引入和传播似乎有助于实施更适当的医疗保健和预防不必要的手术。
