Who is Numero Uno in the PearlDiver Database!! Are You Surprised?

For what pain in their body do more people seek out their orthopedist than any other? Is it sore backs, aching hips, sore knees, fingers? A look into PearlDiver, an orthopedic database of over 22 million patients and 120 million patient records, reveals the answer. An analysis of this orthopedic database reveals that 3.8 million records concern problems with spine and 3.5 million are about issues with large joints. Extremities, including associated trauma patients, represent the highest number with over 4.2 million patients.

While orthopedics is still more about hips, knees, and spines, extremities have been getting more attention in recent years. Most surprising is the fact that the “Numero Uno” diagnosis within the PearlDiver database is Pain in Joint, Shoulder Region (719.41). This diagnosis does not just represent the highest count in the extremities region but in the entire orthopedic sector as well.

Pain in shoulder joint involves patients with pain in the clavicle, scapula region affecting the acromioclavicular joint, sternoclavicular joint, shoulder joint, and also the glenohumeral joint. Baby boomers of both genders, from athletes to office workers, suffer with this joint pain and endure the frustration of the diagnosis.

According to the PearlDiver Patient Record Database, pain in joint, shoulder region represents over a million patients (1,012,080 patients) surpassing every other diagnoses related to orthopedics. The closest diagnosis that comes anywhere in the vicinity of the pain in joint shoulder diagnoses is the degeneration of lumbar or lumbosacral intervertebral disc (ICD-9-D-722.52). This represents about 586,510 distinct patients followed by plantar fascial fibromatosis in third. The following chart shows the top orthopedic diagnoses within the PearlDiver database.

Chart 1: Top Orthopedic Diagnoses, January 2004 – June 2007
Source: PearlDiver Patient Record Database, January 2004 – June 2007

Shoulders, among the most-used body parts within the boomer market, are the third most replaced joints behind hips and knees. Though hips and knees share a majority within the joint market, the shoulder has been making its presence felt in recent years. Since January 2004 the number of patients diagnosed withpain in joint, shoulder region has been increasing at a double digit growth rate. PearlDiver data reports an astounding 45% growth from January 2004 to June 2007. With the number of shoulder patients rising at a steady rate, PearlDiver foresees a similar growth pattern in the coming years.

Chart 2 below demonstrates pain in shoulder joint’s growth since 2004 and its projected growth until 2010. The projection is based on data from the United States Agency for Healthcare and Research, American Academy of Orthopedic Surgeons (AAOS) and the PearlDiver database. Our data also shows patients in the age range of 65 years and above represent between 35 to 40 % of the shoulder joint pain population. According to AAOS data, the number of patients visiting doctors for shoulder pain grew over 20% from 1999 to 2005. The following chart provides the national number estimates produced through PearlDiver resources and other research sites mentioned earlier.

Chart 2: Pain in Joint, Shoulder Patient 2004-2010E

Source: AAOS, United States agency for Healthcare, PearlDiver Patient Record Database and Future Estimates 2004-2010E

With almost 2.5 million patients with joint problems of some sort that reside in our database, 1.01 millions are pain in shoulder joint patients. Hip and knee joint pain do not come close to the numbers shoulders stack up. The following list shows the top five joint problems with their patient counts.

1. Pain in joint shoulder region (719.41) holds the top spot, not just in the joint region but in the entire database with over 1.01 million distinct patients
2. Pain in joint lower leg (719.46) represents over 350,000 patients and also ranks as the number one diagnoses within knee orthopedics
3. Effusion of lower leg joint (719.06) represents the third highest joint problem within our database with almost 250,000 patients
4. Pain in joint foot and ankle (719.47) ranks next with approximately 125,000 distinct patients and represents the second highest joint problem within the extremities category
5. Pain in joint pelvic region and thigh (719.45) has 108,000 patients and ranks as the number one diagnosis in the hips region of orthopedics

Table 1: Associated Procedures January, 2004-June 2007

Source: PearlDiver Patient Record Database, January 2004 – June 2007

Arthrocentesis is the primary surgical procedure for patients with joint pain in the shoulder region. The charges average $124 annually. Arthroscopy with acromioplasty is the more expensive treatment with an average charge of $1,720 annually. In severe cases, where other procedures fail, shoulder replacement surgery is an option. The PearlDiver data base contains records of over 1,500 patients who underwent shoulder replacement. Six hundred of the procedures were performed on patients who had been diagnosed with severe pain in their shoulder joints. The average charge for the surgery on each of the 600 patients was $13,600.

Shoulders, which now represent the third largest sector in orthopedics in terms of dollars behind spine and large joints, offers a market potential in the U.S. close to $300 million. Exactech reported a first quarter growth in its shoulder product line of 132% compared to the first quarter of 2007.

Zimmer Holdings also reported a 31% growth in its extremities market which consists primarily of shoulder products. The market potential for products dealing with shoulder region is large, possibly reaching the level of a billion dollar franchise within the next decade. For more information on the shoulder market, visitOrthopedics This Week’s book store page at http://www.ryortho.com/bookstore.htm.