SECULAR TRENDS IN SHOULDER SURGERY IN THE UK BETWEEN 2000-2018

Robinson, D.E.; Craig, R.; Lane, J.; Andrew, A.; Bailey, J.; Yu, D.; Jordan, K.P.; Peat, G.; Wilkie, R.; Silman, A.; Carr, A.; Strauss, V.Y.; Prieto-Alhambra, D.

Abstract

Objective: Recent RCTs have demonstrated little efficacy of certain shoulder surgeries. To investigate the trend in shoulder surgery incidence over time overall and by surgery type.

Methods: Data were obtained from UK primary care electronic healthcare records (CPRD GOLD) linked to English hospital admissions data. Shoulder surgeries in patients aged 35+ were identified using OPCS-4 codes and categorised into 5 hierarchical groups: Decompression (D), Rotator cuff repair (RCR), Stabilising surgery (SS), Arthroplasty (A) and Other (O). Crude incidence rates and 95%CIs of each type of shoulder surgery were calculated per 10,000 person-years for each calendar year. Jointpoint regression was used to identify changes in trends of surgery over time.

Results: 32,557 shoulder surgeries were identified of which 35.4% were D, 21.5% RCR, 5.7% SS, 15.2% A and 24% O. The number of shoulder surgeries rose from 444/1,263,315 in 2000 (3.51 per 10,000 [3.20, 3.86])
to 3,063/1,672,517 by 2014 (18.66 per 10,000 [17.97,19.38]) before decreasing to 725/544,903 by 2018 (13.31 per 10,000 [12.35, 14.31]). Figure 1 shows the secular trends for the 5 types of shoulder surgery, where dramatic changes in D and RCR were particularly observed. The incident rate for D surgeries was peaked at 7.47 (95%CI: 7.07, 7.87) per 10,000 in 2011, as identified by jointpoint regression. Similarly, RCR’s incident rate rose and was peaked at 4.61 (4.27, 4.97) per 10,000 in 2014. By contrast, rates of A and SS continue to rise.

Conclusion: Shoulder surgeries increased in the UK between 2000-2014 to then decrease for the following 4 y. This decrease was led by D, RCR and O surgeries, potentially due to uncertainty of D and RCR by trial evidence.

Acknowledgement: Versus Arthritis project number 21403 and support by the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre (BRC).

Citation

Robinson, D., Craig, R., Lane, J., Andrew, A., Bailey, J., Yu, D., …Prieto-Alhambra, D. (2020, August). SECULAR TRENDS IN SHOULDER SURGERY IN THE UK BETWEEN 2000-2018. Poster presented at World Congress on Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (WCO-IOF-ESCEO 2020), Spain (virtual)

• Presentation Conference Type: Poster
• Conference Name: World Congress on Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (WCO-IOF-ESCEO 2020)
• Conference Location: Spain (virtual)
• Deposit Date: Jun 27, 2023