Arthroscopy and the dramatic increase in frequency of anterior acromioplasty from 1980 to 2005: an epidemiologic study.
OBJECTIVE
The purposes of this study was to better understand the utilization of anterior acromioplasty over time, in the absence of rotator cuff repair; to examine the relation to patient characteristics (age, sex) and types of rotator cuff pathology (inflammation or fibrosis, partial-thickness tearing, full-thickness tearing undergoing debridement); and to assess the utilization of arthroscopy in this procedure.


METHODS
Using the resources of the Rochester Epidemiology Project, cataloging medical records of residents in Olmsted County, Minnesota, we identified 246 patients who underwent anterior acromioplasty between 1980 and 2005. It has previously been shown that rarely does a resident of Olmsted County undergo an orthopaedic procedure at a facility outside the county.


RESULTS
The incidence of anterior acromioplasty increased over time (P < .001), with crude rates of 3.3 per 100,000 persons in 1980 to 1985 and 19.0 per 100,000 persons in 2000 to 2005. Sex, age, and types of rotator cuff pathology did not significantly change over the 26-year period. There was a dramatic shift from use of the open approach to the arthroscopic approach over this time period (P < .001) and a decrease in the concomitant performance of distal clavicle resection (P < .001).


CONCLUSIONS
The frequency of anterior acromioplasty has dramatically increased over time. Increasing knowledge about this syndrome, including better imaging, has facilitated patient treatment for a stable spectrum of rotator cuff pathology (inflammation or fibrosis, partial-thickness tearing, full-thickness tearing undergoing debridement), as has the application of endoscopic surgery.


METHODS
Level III, epidemiologic study.
Yu
Elizabeth
E
Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota 55905, USA.
Cil
Akin
A
Harmsen
William Scott
WS
Schleck
Cathy
C
Sperling
John W
JW
Cofield
Robert H
RH
D000174:Acromion / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001182:Arthroscopy / Q000379:methods / Q000706:statistics & numerical data / Q000639:trends*; D003646:Debridement; D005260:Female; D005355:Fibrosis; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D019637:Orthopedic Procedures / Q000706:statistics & numerical data; D017006:Rotator Cuff / Q000473:pathology / Q000601:surgery; D000070636:Rotator Cuff Injuries; D019534:Shoulder Impingement Syndrome / Q000453:epidemiology / Q000601:surgery*; D052256:Tendinopathy / Q000150:complications / Q000453:epidemiology / Q000601:surgery*; D014947:Wounds and Injuries / Q000453:epidemiology; D055815:Young Adult