Purpose
The purpose of this study was to evaluate national trends in the surgical setting
and hospital costs of shoulder arthroscopy and rotator cuff repair (RCR) using the
Florida State surgical database and national inpatient database.
Methods
In part I we analyzed population-adjusted shifts in RCR technique (arthroscopic v open) in the Florida surgical database from 2000-2007 and quantified the procedural
codes associated with arthroscopic and open RCR. In part II we analyzed the Nationwide
Inpatient Sample database from 2001-2009 for the total number of inpatient RCRs, the
inpatient hospital type (rural, urban non-teaching, or urban teaching), and the cost.
Results
Part I showed a 163% increase in outpatient procedures in Florida, with a 353% increase
in arthroscopic RCRs. There was a concurrent decrease in open RCRs; however, the overall
trend was a 2-fold increase in total RCRs. Associated procedures such as subacromial
decompression, distal clavicle resection, and extensive glenohumeral debridement increased
by 440%, 589%, and 1,253%, respectively. Part II showed an overall 58.8% decrease
in inpatient RCRs that was similar across all hospital settings, with an increase
in RCR-associated hospital charges by 144.9%, whereas hospital costs only increased
by 85.2%.
Conclusions
The study confirms a shift toward arthroscopic RCR and associated procedures in the
outpatient setting. The increased financial cost partly explains the shift; nevertheless,
future studies are needed to further examine national trends.
Clinical Relevance
This study examining RCR trends by hospital type, cost, and setting further elucidates
how orthopaedic surgery practice is evolving with the implementation of arthroscopic
RCR in the past decade.
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Article info
Publication history
Published online: January 27, 2014
Accepted:
November 20,
2013
Received:
April 19,
2013
Footnotes
The authors report that they have no conflicts of interest in the authorship and publication of this article.
Identification
Copyright
© 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
