2017 ISAKOS Biennial Congress ePoster #2135

 

Treatment Efficacy Of Degenerative Shoulder Lesions Did Not Improve In Denmark From 1996 To 2013. A Registry Study Of 244.519 Patients.

Nina Monrad, MD, Copenhagen DENMARK
Ann Ganestam, MD, Copenhagen DENMARK
Thomas Kallemose, MSc, Copenhagen DENMARK
Kristoffer W. Barfod, MD, PhD, Virum DENMARK

Copenhagen University Hospital Hvidovre, Copenhagen, DENMARK

FDA Status Not Applicable

Summary

This is a nationwide registry study investigating 244.519 patients with degenerative shoulder lesions in Denmark from 1996 to 2013. The number of operations peaked in 2008 and fell to the half in 2013. The prognosis of having ongoing shoulder pain 2 years after diagnosis did not change over the study period indicating that treatment hasn’t improved over the past 18 years.

Abstract

Background

Degenerative shoulder lesions are common and difficult to treat.

Purpose

/ Aim of Study: The purpose of the study was to investigate treatment of degenerative shoulder lesions in Denmark from 1996 to 2013 with focus on incidence of surgical procedures, treatment efficacy and the risk of developing frozen shoulder.

Materials And Methods

The National Patient Registry was retrospectively searched to find the number of degenerative shoulder lesions in Denmark during the period 1996– 2013. Regional population data were retrieved from the services of Statistics Denmark. Risk estimates were analyzed by logistic regression models .

Findings

Results

During the 18-year period, 244.519 individual contacts with a DM 75 diagnosis were registered. Of those 28% received surgical treatment due to their shoulder condition. The probability of being operated given you had degenerative shoulder disease was 25% in 1996, rose to 32% in 2008 and dropped to 16% in 2013. Odds ratio for being operated in 2013 compared to 2008 was 0.41, p < 0.001. Patients aged 31-70 had twofold odds of surgery compared to patients aged 18-30 or above 70, p<,001. the risk of continued shoulder problems 2 years from time diagnosis did not change significantly over 18-year study period; highest was 14% for people aged 31-50 and lowest 7%>70. The risk of developing frozen shoulder after a shoulder operation was 3.8% in 1996 and 1.7% in 2013.

Conclusions

The prognosis of having ongoing shoulder pain 2 years after diagnosis did not change over the study period indicating that treatment hasn’t improved over the past 18 years. The probability of being operated given you had degenerative shoulder disease peaked in 2008 after which the probability was halved. This coincides with high quality trials questioning the effect of subacromial decompression.