Researchers from Boston have found wide variation in the use of common upper extremity procedures such as rotator cuff repair, shoulder arthroscopy and carpal tunnel release.
“Our data shows substantial age and demographic differences in the utilization of these commonly performed upper extremity ambulatory procedures,” Nitin Jain, MD, MSPH, and colleagues wrote in their study. “While over one million upper extremity procedures of interest were performed, evidence-based clinical indications for these procedures remain poorly defined.”
Jain and researchers combined U.S. Census Bureau and National Survey of Ambulatory Surgery data to estimate the number of carpal tunnel releases, rotator cuff repair, non-rotator cuff repair shoulder arthroscopies and non-carpal tunnel release wrist arthroscopies performed in 2006.
Overall, carpal tunnel release had the highest rate of use, ranging from 44.2 per 10,000 persons for patients aged 75 years and older to 37.3 per 10,000 persons for patients aged 45 years to 64 years. For rotator cuff repairs, patients aged 65 years to 74 years had the highest use (28.3 per 10,000 persons).
While the most common reported indications for shoulder arthroscopy not related to rotator cuff repair included impingement, bursitis and SLAP tears; wrist arthroscopy for non-carpal tunnel cases was frequently performed for articular cartilage disorders and diagnostic reasons.–by Christian Ingram
Disclosures: Jain receives funding from National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) project number 1K23AR059199, Foundation for PM&R and Biomedical Research Institute at Brigham and Women’s Hospital. Co-authors Katz and Losina are supported by NIAMS P60 AR 47782, T32 AR 055885, while Losina is supported by NIAMS K24 AR 057827. Co-author Collins is supported by NIAMS T32 AR 055885.