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Increase in Use of Medial Ulnar Collateral Ligament Repair of the Elbow: A Large Database Analysis

PURPOSE: To assess the current national rate of medial ulnar collateral ligament (MUCL) repair of the elbow and delineate the patient demographics of those undergoing repair. METHODS: A retrospective review and analysis of a national private insurance database was conducted covering 2007-2017 using...

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Autores principales: Danilkowicz, Richard M., O’Connell, Robert S., Satalich, James, O’Donnell, Jeffrey A., Flamant, Etienne, Vap, Alexander R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8129461/
https://www.ncbi.nlm.nih.gov/pubmed/34027465
http://dx.doi.org/10.1016/j.asmr.2020.12.004
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author Danilkowicz, Richard M.
O’Connell, Robert S.
Satalich, James
O’Donnell, Jeffrey A.
Flamant, Etienne
Vap, Alexander R.
author_facet Danilkowicz, Richard M.
O’Connell, Robert S.
Satalich, James
O’Donnell, Jeffrey A.
Flamant, Etienne
Vap, Alexander R.
author_sort Danilkowicz, Richard M.
collection PubMed
description PURPOSE: To assess the current national rate of medial ulnar collateral ligament (MUCL) repair of the elbow and delineate the patient demographics of those undergoing repair. METHODS: A retrospective review and analysis of a national private insurance database was conducted covering 2007-2017 using Pearl Diver technologies. All patients diagnosed with a MUCL injury and those who underwent repair were included using Clinical Modification and Current Procedural Terminology code 24345, referencing repair of the ulnar collateral ligament of the elbow with local tissue. The extracted data included patient age at time of procedure, sex, race, region, year of surgery, insurance type, hospital setting, and any associated diagnoses with 90 days of the repair procedure. Standard descriptive methods characterized our study sample to calculate frequency counts and percentages. Means with respective standard deviations and/or standard errors, and 95% confidence intervals were calculated and reported for continuous variables, whereas frequencies and percentages were reported for categorical variables. Pearson χ(2) tests were used to determine differences between group proportion categorical variables. Significance was considered at a P ≤ .05. RESULTS: From 2007 to 2014, MUCL injuries showed an upward trend in incidence per 100,000 from 4.59 to 7.19 (56% increase) within the database population. Accordingly, the incidence of MUCL repair rose from 0.016 to 0.49 (2962%). However, from 2015-2017 there was a drop in both categories, as injury incidence fell from 7.19 to 1.48 whereas repair rates dropped from 0.49 to 0.012. The ages undergoing repair show a significant peak in 15-24-year-olds. The incidence of MUCL repair was greatest in the West and South (P < .01). Male patients had a greater incidence of MUCL injury, and a greater incidence of MUCL repair per 100,000 persons compared to females (P < .01). CONCLUSIONS: MUCL repair has emerged as a viable alternative to reconstruction in select indications. The impetus for this change may be to provide a quicker return to sport and fewer complications, largely due to recent improvements in surgical technique for MUCL repair. As anticipated, the incidence of MUCL repair had steadily increased in the United States from 2007 to 2014, with a subsequent relatively inexplicable decrease primarily in 2017, according to the database utilized in this study. The 15-24 year-old age group encompassing young athletes has the greatest incidence of repair by a significant margin. LEVEL OF EVIDENCE: IV, Therapeutic Case Series.
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spelling pubmed-81294612021-05-21 Increase in Use of Medial Ulnar Collateral Ligament Repair of the Elbow: A Large Database Analysis Danilkowicz, Richard M. O’Connell, Robert S. Satalich, James O’Donnell, Jeffrey A. Flamant, Etienne Vap, Alexander R. Arthrosc Sports Med Rehabil Original Article PURPOSE: To assess the current national rate of medial ulnar collateral ligament (MUCL) repair of the elbow and delineate the patient demographics of those undergoing repair. METHODS: A retrospective review and analysis of a national private insurance database was conducted covering 2007-2017 using Pearl Diver technologies. All patients diagnosed with a MUCL injury and those who underwent repair were included using Clinical Modification and Current Procedural Terminology code 24345, referencing repair of the ulnar collateral ligament of the elbow with local tissue. The extracted data included patient age at time of procedure, sex, race, region, year of surgery, insurance type, hospital setting, and any associated diagnoses with 90 days of the repair procedure. Standard descriptive methods characterized our study sample to calculate frequency counts and percentages. Means with respective standard deviations and/or standard errors, and 95% confidence intervals were calculated and reported for continuous variables, whereas frequencies and percentages were reported for categorical variables. Pearson χ(2) tests were used to determine differences between group proportion categorical variables. Significance was considered at a P ≤ .05. RESULTS: From 2007 to 2014, MUCL injuries showed an upward trend in incidence per 100,000 from 4.59 to 7.19 (56% increase) within the database population. Accordingly, the incidence of MUCL repair rose from 0.016 to 0.49 (2962%). However, from 2015-2017 there was a drop in both categories, as injury incidence fell from 7.19 to 1.48 whereas repair rates dropped from 0.49 to 0.012. The ages undergoing repair show a significant peak in 15-24-year-olds. The incidence of MUCL repair was greatest in the West and South (P < .01). Male patients had a greater incidence of MUCL injury, and a greater incidence of MUCL repair per 100,000 persons compared to females (P < .01). CONCLUSIONS: MUCL repair has emerged as a viable alternative to reconstruction in select indications. The impetus for this change may be to provide a quicker return to sport and fewer complications, largely due to recent improvements in surgical technique for MUCL repair. As anticipated, the incidence of MUCL repair had steadily increased in the United States from 2007 to 2014, with a subsequent relatively inexplicable decrease primarily in 2017, according to the database utilized in this study. The 15-24 year-old age group encompassing young athletes has the greatest incidence of repair by a significant margin. LEVEL OF EVIDENCE: IV, Therapeutic Case Series. Elsevier 2021-04-15 /pmc/articles/PMC8129461/ /pubmed/34027465 http://dx.doi.org/10.1016/j.asmr.2020.12.004 Text en © 2021 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Article
Danilkowicz, Richard M.
O’Connell, Robert S.
Satalich, James
O’Donnell, Jeffrey A.
Flamant, Etienne
Vap, Alexander R.
Increase in Use of Medial Ulnar Collateral Ligament Repair of the Elbow: A Large Database Analysis
title Increase in Use of Medial Ulnar Collateral Ligament Repair of the Elbow: A Large Database Analysis
title_full Increase in Use of Medial Ulnar Collateral Ligament Repair of the Elbow: A Large Database Analysis
title_fullStr Increase in Use of Medial Ulnar Collateral Ligament Repair of the Elbow: A Large Database Analysis
title_full_unstemmed Increase in Use of Medial Ulnar Collateral Ligament Repair of the Elbow: A Large Database Analysis
title_short Increase in Use of Medial Ulnar Collateral Ligament Repair of the Elbow: A Large Database Analysis
title_sort increase in use of medial ulnar collateral ligament repair of the elbow: a large database analysis
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8129461/
https://www.ncbi.nlm.nih.gov/pubmed/34027465
http://dx.doi.org/10.1016/j.asmr.2020.12.004
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