Hodgins Justin L, Vitale Mark, Arons Raymond R, Ahmad Christopher S
Center for Shoulder, Elbow, and Sports Medicine, Columbia University Medical Center, New York, New York, USA.
ONS Foundation for Clinical Research and Education, Greenwich Hospital, Yale-New Haven Health, Greenwich, Connecticut, USA.
Am J Sports Med. 2016 Mar;44(3):729-34. doi: 10.1177/0363546515622407. Epub 2016 Jan 21.
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.
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.
Descriptive epidemiology study.
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.
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).
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.
尽管职业棒球中肘关节内侧尺侧副韧带（UCL）重建的患病率有所上升，且在媒体上颇受关注，但尚无基于人群的研究来调查UCL重建的发生率。
研究10年间全州范围内UCL重建的流行病学趋势。主要终点是随时间推移UCL重建的年发生率；次要终点包括患者人口统计学特征、机构手术量以及尺神经的相关手术。
描述性流行病学研究。
纽约州全州规划与研究合作系统（SPARCS）数据库包含纽约州每次门诊出院记录。该数据库用于通过门诊现行程序术语（CPT - 4，第4版）代码识别2002年至2011年纽约州所有的UCL重建手术。评估内容包括患者年龄、性别、种族、保险状况、相关手术以及医院手术量。
2002年至2011年，纽约州进行的UCL重建手术数量每年显著增加（P <.001）。UCL重建手术量增加了193%，每10万人口的发生率从0.15增至0.45，增长了两倍。平均年龄±标准差为21.6 ± 8.89岁，17至18岁和19至20岁患者的UCL重建频率呈显著上升趋势（P <.001）。男性患者进行UCL重建的可能性是女性患者的11.8倍（P <.001），拥有私人保险的个体进行UCL重建的可能性是拥有医疗补助的个体的25倍（P =.0014）。在研究期间，同期进行的尺神经松解/转位手术增加了400%，这表明在UCL重建时尺神经手术的频率显著增加（P <.001）。
纽约州UCL重建的频率在稳步上升，在青少年运动员中越来越普遍。在当今青少年棒球运动中，强调关于过度使用投掷损伤风险的公众教育以及遵守预防指南的重要性至关重要。
