Trends in Acromioplasty Utilization During Arthroscopic Rotator Cuff Repair: An Epidemiological Study of 139,586 Patients.

Abstract

Acromioplasty remains very common during rotator cuff repair (RCR) despite limited evidence of clinical efficacy. This study observed the incidence of acromioplasty from 2010 to 2018 in Texas using a publicly available database. A total of 139,586 records were analyzed from the Texas Healthcare Information Collection database ranging from 2010 to 2018. These cases were divided into those with and without acromioplasty (N = 107,427 and N = 32,159, respectively). Acromioplasty use was standardized as the number of acromioplasties per RCR (acromioplasty rate). Two subgroup analyses were conducted: surgical institution type and payor status. In 2010, acromioplasty occurred in 84% of all RCR cases with nearly continuous decline to 74% by 2018 (P < 0.001). All subgroups followed this pattern except teaching hospitals which displayed insignificant change from 2010 to 2018 (P = 0.99). The odds of receiving acromioplasty in patients with neither Medicare nor Medicaid was higher than those with Medicare or Medicaid coverage (odds ratio = 1.36, P < 0.001). Overall acromioplasty rates decreased modestly, but markedly, beginning in 2012. Despite this small decrease in acromioplasty rate, it remains a commonly performed procedure in conjunction with RCR. Both the academic status of the surgical facility and the payor status of the patient affect the acromioplasty rate.