Epidemiology of Medial Ulnar Collateral Ligament Reconstruction: A 10-Year Study in New York State
Epidemiology of Medial Ulnar Collateral Ligament Reconstruction: A 10-Year Study in New York State
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DOI：
10.1177/0363546515622407
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发表时间：
2016-03-01
影响因子：
4.8
通讯作者：
Ahmad, Christopher S.
中科院分区：
文献类型：
--
作者：
Hodgins, Justin L.;Vitale, Mark;Ahmad, Christopher S.
工作背景：尽管在职业棒球和媒体内流行的肘部内侧尺侧副韧带（UCL）重建的患病率增加，有没有人口为基础的研究探讨UCL reconstruction.Purpose的发病率：检查UCL重建在全州范围内的流行病学趋势超过10年的时间。主要终点是随着时间的推移UCL重建的年发生率;次要终点包括患者的人口统计学资料，机构的数量，并伴随程序的尺nerve.Study设计：描述性epidemiologystudy.Methods：纽约全州规划和研究合作系统（SPARCS）数据库包含记录每个门诊出院纽约州。该数据库用于识别2002年至2011年纽约州使用门诊CPT-4（当前手术术语，第4版）代码进行的所有UCL重建。评估患者的年龄，性别，种族，保险状况，和相关的程序，以及医院volume.Results：有一个显着的每年增加的UCL重建的数量（P < .001）在纽约州从2002年至2011年。UCL重建量增加了193%，每10万人口的比率从0.15增加到0.45。平均SD年龄为21.6 ± 8.89岁，年龄在17 - 18岁和19 - 20岁的患者中，UCL重建的频率有明显增加的趋势（P <0.001）。男性患者进行UCL重建的可能性是女性患者的11.8倍（P <0.001），拥有私人保险的个人进行UCL重建的可能性是医疗补助的25倍（P = 0.0014）。在研究期间，随着时间的推移，伴随的尺神经松解/移位增加了400%，这表明在UCL重建时尺神经手术的频率显著增加（P <0.001）。结论：UCL重建的频率在纽约州稳步上升，在青少年运动员中越来越常见。强调对过度使用投掷伤害的风险和坚持预防指导方针的重要性的公众教育是至关重要的，在青年棒球今天。
Background: Despite an increase in the prevalence of medial ulnar collateral ligament (UCL) reconstruction of the elbow in professional baseball and popularity within the media, there are no population-based studies examining the incidence of UCL reconstruction.Purpose: To examine the epidemiological trends of UCL reconstruction on a statewide level over a 10-year period. The primary endpoint was the yearly rate of UCL reconstruction over time; secondary endpoints included patient demographics, institution volumes, and concomitant procedures on the ulnar nerve.Study Design: Descriptive epidemiology study.Methods: The New York Statewide Planning and Research Cooperative System (SPARCS) database contains records for each ambulatory discharge in New York State. This database was used to identify all UCL reconstructions in New York State from 2002 to 2011 using the outpatient CPT-4 (Current Procedural Terminology, 4th Revision) code. Assessed were patient age, sex, ethnicity, insurance status, and associated procedures, as well as hospital volume.Results: There was a significant yearly increase in the number of UCL reconstructions (P < .001) performed in New York State from 2002 to 2011. The volume of UCL reconstructions increased by 193%, and the rate per 100,000 population tripled from 0.15 to 0.45. The mean SD age was 21.6 +/- 8.89 years, and there was a significant trend for an increased frequency in UCL reconstruction in patients aged 17 to 18 and 19 to 20 years (P < .001). Male patients were 11.8 times more likely to have a UCL reconstruction than female patients (P < .001), and individuals with private insurance were 25 times more likely to have a UCL reconstruction than those with Medicaid (P = .0014). There was a 400% increase in concomitant ulnar nerve release/transposition performed over time in the study period, representing a significant increase in the frequency of ulnar nerve procedures at the time of UCL reconstruction (P < .001).Conclusion: The frequency of UCL reconstruction is steadily rising in New York State and becoming more common in adolescent athletes. Emphasis on public education on the risks of overuse throwing injuries and the importance of adhering to preventative guidelines is essential in youth baseball today.