■儿童和青少年患者的肩关节不稳可以通过关节镜或开放手术进行手术治疗,但缺乏证据支持这些治疗方式随着时间的推移而发生。假设关节镜肩关节稳定手术的总体速率将随着时间的推移而增加。鉴于开放式稳定技术的进步,我们还假设开放程序的比率可能会增加。
■在2009年至2019年期间,查询了19岁或19岁以下因肩关节不稳和小儿骨科手术而接受关节镜或开放手术的患者的儿科健康信息系统数据库。来自52家儿科医院中37家的儿科健康信息系统数据被纳入分析。对关节镜和开放手术的年发病率和总发病率进行了估计,以及95%的置信区间。还检查了继发性(同侧翻修)或原发性对侧关节镜和开放式手术的年发生率。
■4747例患者接受了初级关节镜手术,384例患者接受了初级开放手术。2009年,每10,000名骨科手术患者中有8.2例主要的开放性肩部稳定手术,2019年下降了19%,为每10,000名骨科手术患者6.7例。关节镜和开放式二次稳定手术均有所增加。2009年,每10,000名骨科手术患者中有0.97例二次关节镜手术。2019年,这一数字增加了672%,达到每10,000名骨科手术患者中的7.5名。2009年没有记录二级开放程序;然而,到2019年,每10,000名骨科手术患者中,二级开放手术增加到2.6例.
这项研究表明,在过去的十年中,美国的原发性关节镜小儿肩关节稳定手术有所增加。原发性开放性肩关节稳定手术的比率略有下降,关节镜和开放性继发性(同侧翻修或原发性对侧)肩关节稳定手术的比率均有所增加。这意味着这一人群的修订负担越来越大。
UNASSIGNED: Shoulder instability in pediatric and adolescent patients can be treated operatively via
arthroscopic or open procedures, but there a paucity of evidence to support the incidence of these treatment modalities over time. It is hypothesized that the overall rate of
arthroscopic shoulder stabilization procedures will increase over time. Given advances in open stabilization techniques, we also hypothesized that the rate of open procedures may be increasing.
UNASSIGNED: The Pediatric Health Information System database was queried for patients 19 years or younger who underwent arthroscopic or open surgery for shoulder instability and pediatric orthopedic surgeries between 2009 and 2019. Data from 37 of the 52 pediatric hospitals with Pediatric Health Information System data was included in the analysis. Annual and overall incidence rates were estimated for
arthroscopic and open procedures, along with 95% confidence intervals. The yearly incidence for secondary (homolateral revisions) or primary contralateral
arthroscopic and open procedures was also examined.
UNASSIGNED: 4747 patients underwent primary arthroscopic procedures and 384 patients had primary open procedures. There were 8.2 primary open shoulder stabilization procedures per 10,000 orthopedic surgical patients in 2009, which decreased by 19% to 6.7 per 10,000 orthopedic surgical patients in 2019. There was an increase seen in both
arthroscopic and open secondary stabilization procedures. In 2009, there were 0.97 secondary arthroscopic procedures per 10,000 orthopedic surgical patients. This increased by 672% to 7.5 per 10,000 orthopedic surgical patients in 2019. No secondary open procedures were recorded in 2009; however, an increase to 2.6 secondary open procedures per 10,000 orthopedic surgical patients was seen by 2019.
UNASSIGNED: This study shows a rise in primary arthroscopic pediatric shoulder stabilization surgeries across the U.S. over the last decade. There was a slight decrease in the rate of primary open shoulder stabilization surgeries and an increase in both arthroscopic and open secondary (homolateral revisions or primary contralateral) shoulder stabilization surgeries, implying an increasing revision burden in this population.