Declining incidence of acromioplasty in Finland

Abstract

Background and purpose — An increased incidence rate of acromioplasty has been reported; we analyzed data from the Finnish National Hospital Discharge Register.

Patients and methods — During the 14-year study period (1998–2011), 68,877 acromioplasties without rotator cuff repair were performed on subjects aged 18 years or older.

Results — The incidence of acromioplasty increased by 117% from 75 to 163 per 10⁵ person years between 1998 and 2007. The highest incidence was observed in 2007, after which the incidence rate decreased by 20% to 131 per 10⁵ person years in 2011. The incidence declined even more at non-profit public hospitals from 2007 to 2011. In contrast, it continued to rise at profit-based private orthopedic clinics.

Interpretation — We propose that this change in clinical practice is due to accumulating high-quality scientific evidence that shows no difference in outcome between acromioplasty and non-surgical interventions for rotator cuff disease with subacromial impingement syndrome. However, the exact cause of the declining incidence cannot be defined based solely on a registry study. Interestingly, this change was not observed at private clinics, where the number of operations increased steadily from 2007 to 2011.

JP: design of study, acquisition of data, analysis and interpretation of data, and writing of the manuscript. VL: design of study, interpretation of data, and critical revision of the manuscript. JK, JY, and VÄ: interpretation of data and critical revision of the manuscript. VM: design of study, acquisition and interpretation of data, and critical revision of the manuscript.

JP, VL, JK, JY, and VM have no competing interests to disclose. JK received personal fees from Abbvie, Mundipharma, MSD, and UCB, unrelated the present work. This work was supported by an Academy of Finland grant.