Université Clermont Auvergne, CHU de Clermont-Ferrand, CNRS, SIGMA Clermont, ICCF, 63000 Clermont-Ferrand, France; Université Clermont Auvergne, Service d'orthopédie, CHU de Clermont-Ferrand, 63000 Clermont-Ferrand, France.
Université Clermont Auvergne, CHU de Clermont-Ferrand, CNRS, SIGMA Clermont, ICCF, 63000 Clermont-Ferrand, France; Université Clermont Auvergne, Service d'orthopédie, CHU de Clermont-Ferrand, 63000 Clermont-Ferrand, France.
Orthop Traumatol Surg Res. 2020 Oct;106(6):1067-1077. doi: 10.1016/j.otsr.2020.04.019. Epub 2020 Aug 27.
Shoulder surgery has been rapidly expanding over the past 20 years and now makes up a large share of orthopedic surgery practice. Data on how this activity has changed is not available in France due to a lack of registries. The study objectives were to: (1) quantify the number of shoulder surgeries in France, (2) predict how this activity will change over the next 50 years based on extreme scenarios.
This study involved an analysis of shoulder surgery data taken from the French hospital discharge database (PMSI). Two mathematical scenarios were applied to define the change over time: the first only considered the evolution in the population and changes in the age brackets over time; the second extrapolated the trends observed over the past few years (2012 to 2018).
In 2018, there were 234,612 procedures coded as primary shoulder surgery procedures in France. This activity increased 24.5% between 2012 and 2018 and is projected to increase 18% to 161% from now to 2050, depending on the scenario (p<0.0001). Rotator cuff surgery procedures were done 173,799 times - of which 61,055 were tendon repair - representing 74% of all shoulder procedures. The scenarios point to an increase of 13.6% to more than 300% (p<0.0001). Primary shoulder arthroplasty corresponded to 17,043 procedures in 2018 (7.3% of all procedures), with a 47% increase between 2012 and 2018. Between 2018 and 2050, the number of total shoulder arthroplasty procedures is expected to increase 31% to 322% (p<0.0001). The total number of revision arthroplasty procedures was 1508, increasing by 39% from 2012 to 2018. There were 14,229 procedures done for anterior or posterior instability in 2018 (6% of total). Bone block procedures made up 53% of these cases. This increased 17% between 2012 and 2018, with a projected increase of 5% to 82% up to 2050 (p<0.01).
Shoulder surgery is the third largest activity in the orthopedic realm after hip and knee surgery, although it has seen the largest increases in recent years. This growth in shoulder procedures should continue over the next decades.
IV, descriptive epidemiology study.
肩部手术在过去 20 年中迅速发展，现已成为矫形外科实践的重要组成部分。由于缺乏登记处，法国尚无关于此类活动变化的数据。本研究的目的是：（1）量化法国的肩部手术数量，（2）根据极端情况预测未来 50 年的变化。
本研究分析了来自法国医院出院数据库（PMSI）的肩部手术数据。应用了两种数学情景来定义随时间的变化：第一种仅考虑人口的演变以及随时间推移的年龄段变化；第二种则推断过去几年（2012 年至 2018 年）的趋势。
2018 年，法国有 234612 例原发性肩部手术。自 2012 年以来，该手术增加了 24.5%，预计到 2050 年，根据不同的情景，该手术将增加 18%至 161%（p<0.0001）。肩袖手术共进行了 173799 次，其中 61055 次为肌腱修复术，占所有肩部手术的 74%。根据不同的情景，该手术预计会增加 13.6%至 300%以上（p<0.0001）。2018 年原发性肩部关节置换术对应 17043 例手术（占所有手术的 7.3%），自 2012 年以来增加了 47%。在 2018 年至 2050 年期间，预计全肩关节置换术的数量将增加 31%至 322%（p<0.0001）。关节翻修术的总数为 1508 例，自 2012 年以来增加了 39%。2018 年有 14229 例前或后不稳定的手术（占总数的 6%）。骨块手术占这些病例的 53%。自 2012 年以来，这一比例增加了 17%，预计到 2050 年，这一比例将增加 5%至 82%（p<0.01）。
肩部手术是矫形外科领域第三大手术，仅次于髋关节和膝关节手术，尽管近年来增长幅度最大。未来几十年肩部手术的增长应会持续。
IV，描述性流行病学研究。
