title: Declining incidence of acromioplasty in Finland.
abstract: OBJECTIVE
  An increased incidence rate of acromioplasty has been reported; we analyzed data from the Finnish National Hospital Discharge Register.
  
  
  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 10(5) person years between 1998 and 2007. The highest incidence was observed in 2007, after which the incidence rate decreased by 20% to 131 per 10(5) 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Surgery, Central Finland Hospital, Keskussairaalantie 19 , 40620 Jyväskylä , Finland.
authors.forename: Juha
authors.initials: J
authors.lastname: Paloneva
authors.forename: Vesa
authors.initials: V
authors.lastname: Lepola
authors.forename: Jaro
authors.initials: J
authors.lastname: Karppinen
authors.forename: Jari
authors.initials: J
authors.lastname: Ylinen
authors.forename: Ville
authors.initials: V
authors.lastname: Äärimaa
authors.forename: Ville M
authors.initials: VM
authors.lastname: Mattila
mesh_terms: D000174:Acromion / Q000601:surgery*; D000328:Adult; D000368:Aged; D001178:Arthroplasty / Q000639:trends*; D016208:Databases, Factual; D005260:Female; D005387:Finland; D016304:Hospitals, Private / Q000706:statistics & numerical data; D006777:Hospitals, Proprietary / Q000706:statistics & numerical data*; D006779:Hospitals, Public / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000639:trends; D010818:Practice Patterns, Physicians' / Q000639:trends*; D019534:Shoulder Impingement Syndrome / Q000601:surgery*