Epidemiological trends and indications of shoulder arthroscopy among 191,549 patients in the United States

Abstract

Purpose

To determine epidemiological trends, demographic variation, and indications for shoulder arthroscopy in the United States (US).

Methods

We queried the TriNetX database to identify patients undergoing shoulder arthroscopy in the US. The sample was stratified by indication, location, age, sex, race, BMI, and two-year intervals. Comparisons were performed using incidence rates and incidence rate ratios. 95% confidence intervals were calculated assuming a Poisson distribution. P-values<0.05 were considered significant.

Results

We identified 191,549 patients who underwent shoulder arthroscopy from 2014–2024. Approximately 55% of patients were male. Most were white (73%), and the Northeast (39%) and South (34%) had the greatest representation among geographic regions. Overall incidence rate was 238.59 procedures per 100,000 patients (95% CI: 237.52–239.66). Patients aged 50–54 years had the greatest incidence rate (589.72 per 100,000). Incidence rates increased significantly with BMI (P < 0.000001) except for BMI>40.0. Rotator cuff repair was the most common indication (65.1%) followed by DCR (26.1%) and biceps tenodesis (22.3%).

Conclusion

Patients undergoing shoulder arthroscopy in the US are primarily older, white, male adults. Rotator cuff repair remains the most common indication. Persistent disparities in utilization exist among racial groups, sexes, and locations. Those with greater BMIs are generally more likely to undergo shoulder arthroscopy.