Trends in Utilization and Patient Demographics for Shoulder Instability Procedures from 2010 to 2019

Document Type

Journal Article

Publication Date

1-18-2022

Journal

Journal of shoulder and elbow surgery

DOI

10.1016/j.jse.2021.12.020

Keywords

Bankart; Latarjet procedure; Shoulder instability; bone block; complication; reoperation/revision

Abstract

INTRODUCTION: Improved technique and increased surgeon experience has optimized surgical care in patients with recurrent shoulder instability. Several techniques are used for surgical repair of shoulder instability, yet there is limited data on how utilization has changed over the past decade. The aim of this study was to assess trends in the utilization rate and patient demographics (age and gender) from 2010-2019 for four shoulder instability procedures: coracoid transfer/Latarjet procedure (LP), anterior bone block (ABB), open Bankart repair (OBR), and arthroscopic Bankart repair (ABR). METHODS: We identified over 87,00 patients using an all-payer claims database. The utilization rate was defined as the number of cases for a procedure divided by the total number surgical cases for shoulder instability for any given year. Age was divided into three groups: <25, 25-35, >35-years-old. Trends were reported in terms of compounded annual growth rates (CAGR). RESULTS: While ABR was the most common shoulder instability procedure overall (91% utilization rate), LP had the greatest increase in utilization from 2010-2019 (2.0% to 4.5%; CAGR: +9.8%). In comparison, the utilization for ABB increased +4.3% annually while OBR declined -6.9% annually. The utilization of ABR showed minimal change. Notably, LP was performed more frequently on younger patients over time. The percentage of patients <25-years-old who underwent LP increased from 30% to 41% from 2010-2019 (+3.4%). There was a trend toward performing more LP on men versus women (+1.2% vs. -3.5%, P < 0.05), although most cases (68%) were still performed on men. CONCLUSION: ABR continues to account for most shoulder instability procedures. LP had the greatest increase in utilization rate from 2010-2019 and has now surpassed OBR in utilization rate. ABB is also being more frequently performed but only represents a minority of stabilization cases. During the course of the study period, a greater percentage of patients undergoing shoulder instability procedure were male and <25-years-old.

Department

School of Medicine and Health Sciences Student Works

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