title: Demographic analysis of open and arthroscopic distal clavicle excision in a private insurance database.
abstract: OBJECTIVE
  The purpose of this study was to evaluate and quantify the demographic characteristics of patients undergoing open and arthroscopic distal clavicle excision (DCE) in the United States while also describing changes in practice patterns over time.
  
  
  METHODS
  Patients who underwent DCE from 2004 to 2009 were identified by Current Procedural Terminology (CPT) codes in a national database of orthopaedic insurance records. The year of procedure, age, sex, geographic region, and concomitant rotator cuff repair or subacromial decompression (SAD) were recorded for each patient. Results were reported as the incidence of procedures identified per 10,000 patients searched in the database.
  
  
  RESULTS
  Between 2004 and 2009, 73,231 DCEs were performed; 74% were arthroscopic and 26% were open. The incidence of arthroscopic DCE increased from 37.8 in 2004 to 58.5 in 2009 (P < .001), whereas the incidence of open DCE decreased from 21.1 in 2004 to 14.1 in 2009 (P < .001). Sixty-one percent of DCEs were performed in men (P < .001). Women were more likely to undergo an arthroscopic procedure (P < .001). Arthroscopic DCE was most common in patients aged 50 to 59 years (P < .001). Open DCE was most common in patients aged 60 to 69 years (P < .001). Open rotator cuff repair and SAD were concomitantly performed in 38% and 23% of open DCEs, respectively. Arthroscopic rotator cuff repair and SAD were concomitantly performed in 33% and 95% arthroscopic DCEs, respectively.
  
  
  CONCLUSIONS
  This analysis of DCE using a private insurance database shows that arthroscopic DCEs progressively increased, whereas open DCEs concomitantly decreased between 2004 and 2009. The majority of DCEs were performed in men between the ages of 50 and 59 years. Both arthroscopic and open DCEs are frequently performed in conjunction with rotator cuff repair or SAD.
  
  
  METHODS
  Level IV, cross-sectional study.
authors.affiliation: Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, U.S.A.
authors.forename: Ram K
authors.initials: RK
authors.lastname: Alluri
authors.affiliation: Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, U.S.A.
authors.forename: Asher I
authors.initials: AI
authors.lastname: Kupperman
authors.affiliation: Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, U.S.A.
authors.forename: Scott R
authors.initials: SR
authors.lastname: Montgomery
authors.affiliation: Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, U.S.A.
authors.forename: Jeffrey C
authors.initials: JC
authors.lastname: Wang
authors.affiliation: Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, U.S.A.. Electronic address: shame@mednet.ucla.edu.
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Hame
mesh_terms: D000174:Acromion / Q000601:surgery; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001182:Arthroscopy / Q000706:statistics & numerical data*; D002968:Clavicle / Q000601:surgery*; D003430:Cross-Sectional Studies; D016208:Databases, Factual / Q000706:statistics & numerical data; D019299:Decompression, Surgical; D003710:Demography; D005260:Female; D006801:Humans; D015994:Incidence; D007359:Insurance, Surgical / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000706:statistics & numerical data*; D009985:Orthopedics / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000639:trends; D017149:Private Sector; D017006:Rotator Cuff / Q000601:surgery; D017678:Sex Distribution; D014481:United States; D055815:Young Adult