Superior labrum anterior-to-posterior repair incidence: a longitudinal investigation of community and academic databases.
BACKGROUND
Superior labrum anterior-to-posterior (SLAP) lesion repair is controversial regarding indications and potential complications.


METHODS
Databases were used to determine the SLAP repair incidence compared with all orthopaedic procedures over a period of 10 years. In part A, the New York Statewide Planning and Research Cooperative System ambulatory surgery database was investigated from 2002 to 2009. In part B, the California Office of Statewide Health Planning and Development ambulatory surgery database was investigated from 2005 to 2009. In part C, the American Board of Orthopaedic Surgery (ABOS) database was investigated from 2003 to 2010.


RESULTS
In part A, from 2002 to 2009, there was a 238% increase in SLAP repair volume compared with a 125% increase in all orthopaedic procedures. In part B, from 2005 to 2009, there was a 20.17% increase in SLAP repair volume compared with a decrease of 13.64% in all orthopaedic procedures. In part C, among candidates performing at least 1 SLAP repair, there was no statistically significant difference in likelihood of performing a SLAP repair (95% confidence interval, 0.973-1.003) in 2010 as compared with 2003 (P > .10).


CONCLUSIONS
There has been a significant increase in the incidence of SLAP repairs in the past 10 years in statewide databases. This pattern was not seen in the ABOS database, in which the annual volume of SLAP repairs remained stable over the same period. This suggests that SLAP lesions have been over-treated with surgical repair but that part II ABOS candidates are becoming more aware of the need to narrow indications.


METHODS
Epidemiology study, database analysis.
Department of Orthopaedic Surgery, New York Presbyterian/Columbia University Medical Center, New York, NY, USA.
Laura A
LA
Vogel
W.B. Carrell Memorial Clinic, Dallas, TX, USA.
Todd C
TC
Moen
Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Alec A
AA
Macaulay
Department of Orthopaedic Surgery, New York Presbyterian/Columbia University Medical Center, New York, NY, USA.
Raymond R
RR
Arons
Department of Orthopaedic Surgery, New York Presbyterian/Columbia University Medical Center, New York, NY, USA.
Edwin R
ER
Cadet
Department of Orthopaedic Surgery, New York Presbyterian/Columbia University Medical Center, New York, NY, USA.
Christopher S
CS
Ahmad
Department of Orthopaedic Surgery, New York Presbyterian/Columbia University Medical Center, New York, NY, USA. Electronic address: wnl1@columbia.edu.
William N
WN
Levine
D000328:Adult; D000556:Ambulatory Surgical Procedures / Q000706:statistics & numerical data; D001182:Arthroscopy / Q000706:statistics & numerical data*; D016208:Databases, Factual; D005260:Female; D051445:Fibrocartilage / Q000293:injuries / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008297:Male; D009518:New York / Q000453:epidemiology; D012785:Shoulder Joint / Q000601:surgery*; D013708:Tendon Injuries / Q000601:surgery*; D014481:United States / Q000453:epidemiology
ABOS; OSHPD; SLAP lesion; SPARCS; incidence