Purpose
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.
Level of Evidence
Level IV, cross-sectional study.
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Article info
Publication history
Published online: May 23, 2014
Accepted:
April 7,
2014
Received:
October 17,
2013
Footnotes
The authors report the following potential conflict of interest or source of funding in relation to this article: J.C.W. receives support from North American Spine Society, Cervical Spine Research Society, Collaborative Spine Research Foundation, Arthritis Foundation, Synthes, Biomet, Aesculap, Osprey, Stryker, Alphatech, Amedica, and Seaspine.
Identification
Copyright
© 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
