Disproportionate trends in ulnar collateral ligament reconstruction: projections through 2025 and a literature review

Background Medial ulnar collateral ligament (UCL) injuries of the elbow that require surgical management are uncommon. There is growing evidence, however, suggesting that the incidence of UCL reconstruction (UCLR) procedures is rapidly increasing. We sought to quantify the incidence of age-related t...

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Veröffentlicht in:Journal of shoulder and elbow surgery 2016-06, Vol.25 (6), p.1005-1012
Hauptverfasser: Mahure, Siddharth A., MD, Mollon, Brent, MD, FRCSC, Shamah, Steven D., BA, Kwon, Young W., MD, PhD, Rokito, Andrew S., MD
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container_end_page 1012
container_issue 6
container_start_page 1005
container_title Journal of shoulder and elbow surgery
container_volume 25
creator Mahure, Siddharth A., MD
Mollon, Brent, MD, FRCSC
Shamah, Steven D., BA
Kwon, Young W., MD, PhD
Rokito, Andrew S., MD
description Background Medial ulnar collateral ligament (UCL) injuries of the elbow that require surgical management are uncommon. There is growing evidence, however, suggesting that the incidence of UCL reconstruction (UCLR) procedures is rapidly increasing. We sought to quantify the incidence of age-related trends for UCLR from 2003 to 2014 and subsequently to project future trends through 2025. We hypothesized that as the total number of UCLRs performed increased, a disproportionate incidence among younger patients would be observed. Methods New York State's Statewide Planning and Research Cooperative System database was queried from 2003 to 2014 to identify individuals between 10 and 40 years old undergoing UCLR. Poisson regression was used to develop future projections for UCLR and New York State population through 2025, and incidence estimates per 100,000 people were calculated. Results In New York State between 2003 and 2014, there were 890 patients who underwent UCLR, with average annual incidence per 100,000 people equaling 6.3 ± 2.8 for ages 15 to 19 years, significantly greater than for all other age groups ( P  
doi_str_mv 10.1016/j.jse.2016.02.036
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There is growing evidence, however, suggesting that the incidence of UCL reconstruction (UCLR) procedures is rapidly increasing. We sought to quantify the incidence of age-related trends for UCLR from 2003 to 2014 and subsequently to project future trends through 2025. We hypothesized that as the total number of UCLRs performed increased, a disproportionate incidence among younger patients would be observed. Methods New York State's Statewide Planning and Research Cooperative System database was queried from 2003 to 2014 to identify individuals between 10 and 40 years old undergoing UCLR. Poisson regression was used to develop future projections for UCLR and New York State population through 2025, and incidence estimates per 100,000 people were calculated. Results In New York State between 2003 and 2014, there were 890 patients who underwent UCLR, with average annual incidence per 100,000 people equaling 6.3 ± 2.8 for ages 15 to 19 years, significantly greater than for all other age groups ( P  &lt; .001). Projections from 2015 through 2025 suggest that incidence in 15- to 19-year-olds and 20- to 24-year-olds will continue to rapidly increase while rates for other age groups will remain relatively stable. Conclusions The number of UCLRs performed between 2003 and 2014 increased by 343%, and a disproportionate trend in average annual incidence for patients between 15 and 19 years old was observed. As our review of the literature questioned outcomes in adolescent athletes after UCLR, continued attempts at preventing these injuries in the young throwing athlete remain paramount.</description><identifier>ISSN: 1058-2746</identifier><identifier>EISSN: 1532-6500</identifier><identifier>DOI: 10.1016/j.jse.2016.02.036</identifier><identifier>PMID: 27197888</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adolescent ; Adult ; Age Factors ; baseball ; Baseball - injuries ; Child ; Collateral Ligament, Ulnar - injuries ; Collateral Ligament, Ulnar - surgery ; elbow injuries ; Elbow Joint - surgery ; Female ; Humans ; Male ; New York ; Orthopedic Procedures - trends ; Orthopedics ; pitching ; Poisson Distribution ; Reconstructive Surgical Procedures - trends ; throwing athlete ; Tommy John surgery ; Ulnar collateral ligament reconstruction ; Young Adult ; youth sports injuries</subject><ispartof>Journal of shoulder and elbow surgery, 2016-06, Vol.25 (6), p.1005-1012</ispartof><rights>Journal of Shoulder and Elbow Surgery Board of Trustees</rights><rights>2016 Journal of Shoulder and Elbow Surgery Board of Trustees</rights><rights>Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. 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All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-2c2784bdf70cd4be01b1643bb153620c51a2233bde1f7925a85ff5ce564b05423</citedby><cites>FETCH-LOGICAL-c474t-2c2784bdf70cd4be01b1643bb153620c51a2233bde1f7925a85ff5ce564b05423</cites><orcidid>0000-0003-3607-7248</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1058274616001440$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27197888$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mahure, Siddharth A., MD</creatorcontrib><creatorcontrib>Mollon, Brent, MD, FRCSC</creatorcontrib><creatorcontrib>Shamah, Steven D., BA</creatorcontrib><creatorcontrib>Kwon, Young W., MD, PhD</creatorcontrib><creatorcontrib>Rokito, Andrew S., MD</creatorcontrib><title>Disproportionate trends in ulnar collateral ligament reconstruction: projections through 2025 and a literature review</title><title>Journal of shoulder and elbow surgery</title><addtitle>J Shoulder Elbow Surg</addtitle><description>Background Medial ulnar collateral ligament (UCL) injuries of the elbow that require surgical management are uncommon. There is growing evidence, however, suggesting that the incidence of UCL reconstruction (UCLR) procedures is rapidly increasing. We sought to quantify the incidence of age-related trends for UCLR from 2003 to 2014 and subsequently to project future trends through 2025. We hypothesized that as the total number of UCLRs performed increased, a disproportionate incidence among younger patients would be observed. Methods New York State's Statewide Planning and Research Cooperative System database was queried from 2003 to 2014 to identify individuals between 10 and 40 years old undergoing UCLR. Poisson regression was used to develop future projections for UCLR and New York State population through 2025, and incidence estimates per 100,000 people were calculated. Results In New York State between 2003 and 2014, there were 890 patients who underwent UCLR, with average annual incidence per 100,000 people equaling 6.3 ± 2.8 for ages 15 to 19 years, significantly greater than for all other age groups ( P  &lt; .001). Projections from 2015 through 2025 suggest that incidence in 15- to 19-year-olds and 20- to 24-year-olds will continue to rapidly increase while rates for other age groups will remain relatively stable. Conclusions The number of UCLRs performed between 2003 and 2014 increased by 343%, and a disproportionate trend in average annual incidence for patients between 15 and 19 years old was observed. As our review of the literature questioned outcomes in adolescent athletes after UCLR, continued attempts at preventing these injuries in the young throwing athlete remain paramount.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Age Factors</subject><subject>baseball</subject><subject>Baseball - injuries</subject><subject>Child</subject><subject>Collateral Ligament, Ulnar - injuries</subject><subject>Collateral Ligament, Ulnar - surgery</subject><subject>elbow injuries</subject><subject>Elbow Joint - surgery</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>New York</subject><subject>Orthopedic Procedures - trends</subject><subject>Orthopedics</subject><subject>pitching</subject><subject>Poisson Distribution</subject><subject>Reconstructive Surgical Procedures - trends</subject><subject>throwing athlete</subject><subject>Tommy John surgery</subject><subject>Ulnar collateral ligament reconstruction</subject><subject>Young Adult</subject><subject>youth sports injuries</subject><issn>1058-2746</issn><issn>1532-6500</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kUtv1TAQhSMEog_4AWyQl2wSxo6d5IKEVBUKSJVYAGvLcSatQ6598QPUf8-EW1iwYOWRdb6jOWeq6hmHhgPvXi7NkrARNDYgGmi7B9UpV62oOwXwkGZQQy162Z1UZyktALCTIB5XJ6Lnu34YhtOqvHXpEMMhxOyCNxlZjuinxJxnZfUmMhvWlf6jWdnqbswefWYRbfApx2I36hUjhwV_z4nl2xjKzS0TIBQzfmKGuI3PJSKRPxz-fFI9ms2a8On9e159vXr35fJDff3p_cfLi-vayl7mWljRD3Kc5h7sJEcEPvJOtuNIITsBVnEjRNuOE_K53wllBjXPyqLq5AhKiva8enH0pQW_F0xZ712ySIE8hpI073cgyVECSflRamNIKeKsD9HtTbzTHPTWtl40ta23tjUITW0T8_zevox7nP4Sf-olweujACkkBY86WYfe4uSowqyn4P5r_-Yf2q7OO2vWb3iHaQklempPc50I0J-3c2_X5h0Al5TpF_tWpnc</recordid><startdate>20160601</startdate><enddate>20160601</enddate><creator>Mahure, Siddharth A., MD</creator><creator>Mollon, Brent, MD, FRCSC</creator><creator>Shamah, Steven D., BA</creator><creator>Kwon, Young W., MD, PhD</creator><creator>Rokito, Andrew S., MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-3607-7248</orcidid></search><sort><creationdate>20160601</creationdate><title>Disproportionate trends in ulnar collateral ligament reconstruction: projections through 2025 and a literature review</title><author>Mahure, Siddharth A., MD ; Mollon, Brent, MD, FRCSC ; Shamah, Steven D., BA ; Kwon, Young W., MD, PhD ; Rokito, Andrew S., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-2c2784bdf70cd4be01b1643bb153620c51a2233bde1f7925a85ff5ce564b05423</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Age Factors</topic><topic>baseball</topic><topic>Baseball - injuries</topic><topic>Child</topic><topic>Collateral Ligament, Ulnar - injuries</topic><topic>Collateral Ligament, Ulnar - surgery</topic><topic>elbow injuries</topic><topic>Elbow Joint - surgery</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>New York</topic><topic>Orthopedic Procedures - trends</topic><topic>Orthopedics</topic><topic>pitching</topic><topic>Poisson Distribution</topic><topic>Reconstructive Surgical Procedures - trends</topic><topic>throwing athlete</topic><topic>Tommy John surgery</topic><topic>Ulnar collateral ligament reconstruction</topic><topic>Young Adult</topic><topic>youth sports injuries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mahure, Siddharth A., MD</creatorcontrib><creatorcontrib>Mollon, Brent, MD, FRCSC</creatorcontrib><creatorcontrib>Shamah, Steven D., BA</creatorcontrib><creatorcontrib>Kwon, Young W., MD, PhD</creatorcontrib><creatorcontrib>Rokito, Andrew S., MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of shoulder and elbow surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mahure, Siddharth A., MD</au><au>Mollon, Brent, MD, FRCSC</au><au>Shamah, Steven D., BA</au><au>Kwon, Young W., MD, PhD</au><au>Rokito, Andrew S., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Disproportionate trends in ulnar collateral ligament reconstruction: projections through 2025 and a literature review</atitle><jtitle>Journal of shoulder and elbow surgery</jtitle><addtitle>J Shoulder Elbow Surg</addtitle><date>2016-06-01</date><risdate>2016</risdate><volume>25</volume><issue>6</issue><spage>1005</spage><epage>1012</epage><pages>1005-1012</pages><issn>1058-2746</issn><eissn>1532-6500</eissn><abstract>Background Medial ulnar collateral ligament (UCL) injuries of the elbow that require surgical management are uncommon. There is growing evidence, however, suggesting that the incidence of UCL reconstruction (UCLR) procedures is rapidly increasing. We sought to quantify the incidence of age-related trends for UCLR from 2003 to 2014 and subsequently to project future trends through 2025. We hypothesized that as the total number of UCLRs performed increased, a disproportionate incidence among younger patients would be observed. Methods New York State's Statewide Planning and Research Cooperative System database was queried from 2003 to 2014 to identify individuals between 10 and 40 years old undergoing UCLR. Poisson regression was used to develop future projections for UCLR and New York State population through 2025, and incidence estimates per 100,000 people were calculated. Results In New York State between 2003 and 2014, there were 890 patients who underwent UCLR, with average annual incidence per 100,000 people equaling 6.3 ± 2.8 for ages 15 to 19 years, significantly greater than for all other age groups ( P  &lt; .001). Projections from 2015 through 2025 suggest that incidence in 15- to 19-year-olds and 20- to 24-year-olds will continue to rapidly increase while rates for other age groups will remain relatively stable. Conclusions The number of UCLRs performed between 2003 and 2014 increased by 343%, and a disproportionate trend in average annual incidence for patients between 15 and 19 years old was observed. As our review of the literature questioned outcomes in adolescent athletes after UCLR, continued attempts at preventing these injuries in the young throwing athlete remain paramount.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>27197888</pmid><doi>10.1016/j.jse.2016.02.036</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-3607-7248</orcidid></addata></record>
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subjects Adolescent
Adult
Age Factors
baseball
Baseball - injuries
Child
Collateral Ligament, Ulnar - injuries
Collateral Ligament, Ulnar - surgery
elbow injuries
Elbow Joint - surgery
Female
Humans
Male
New York
Orthopedic Procedures - trends
Orthopedics
pitching
Poisson Distribution
Reconstructive Surgical Procedures - trends
throwing athlete
Tommy John surgery
Ulnar collateral ligament reconstruction
Young Adult
youth sports injuries
title Disproportionate trends in ulnar collateral ligament reconstruction: projections through 2025 and a literature review
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