Degen Ryan M, Camp Christopher L, Bernard Johnathan A, Dines David M, Altchek David W, Dines Joshua S
From the Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, NY.
J Am Acad Orthop Surg. 2017 Feb;25(2):140-149. doi: 10.5435/JAAOS-D-16-00102.
Ulnar collateral ligament (UCL) reconstructions are being performed with an increasing annual incidence. The purpose of this study was to evaluate trends in UCL surgery among recently trained orthopaedic surgeons.
The American Board of Orthopaedic Surgeons (ABOS) database was used to identify all UCL reconstructions from 2004 to 2013. Procedures were identified by Current Procedural Terminology (CPT) codes and verified by International Classification of Disease, Ninth Revision (ICD-9) codes. Data on surgeon fellowship, practice location, concomitant surgical procedures, and complications were collected.
One hundred sixty-four UCL reconstructions were performed by 133 ABOS Part II candidates. The annual incidence increased from 1.52 to 3.46 cases per 10,000 (P = 0.042). Reconstructions were most commonly performed by surgeons with fellowship training in sports medicine (65.9%), hand and upper extremity (18.9%), and shoulder and elbow (9.1%). Most reconstructions were performed in isolation (57.3%), or with ulnar nerve transposition (32.9%) or elbow arthroscopy (9.8%). Concomitant elbow arthroscopy rates decreased significantly (P = 0.022). Complications occurred in 9.8% of cases, although the rates did not significantly change (P = 0.466).
UCL reconstructions are being performed with increasing frequency. Concomitant procedure rates remained the same, although arthroscopy was less commonly performed. Complication rates did not change considerably over the observed period. Further study of the surgical trends and associated long-term outcomes is warranted.
Level IV.
尺侧副韧带（UCL）重建手术的年发病率呈上升趋势。本研究旨在评估近期接受培训的骨科医生进行UCL手术的趋势。
使用美国骨科医师委员会（ABOS）数据库识别2004年至2013年间所有的UCL重建手术。通过现行手术操作术语（CPT）编码确定手术，并经国际疾病分类第九版（ICD-9）编码验证。收集有关外科医生的进修经历、执业地点、同期进行的手术操作以及并发症的数据。
133名ABOS第二部分考试候选人共进行了164例UCL重建手术。年发病率从每10000人1.52例增至3.46例（P = 0.042）。重建手术最常由接受过运动医学进修培训的外科医生进行（65.9%），其次是手与上肢（18.9%）以及肩肘（9.1%）。大多数重建手术是单独进行的（57.3%），或与尺神经移位术（32.9%）或肘关节镜检查（9.8%）同时进行。同期肘关节镜检查率显著下降（P = 0.022）。9.8%的病例出现并发症，尽管发生率没有显著变化（P = 0.466）。
UCL重建手术的实施频率在增加。同期手术率保持不变，不过关节镜检查的实施频率降低。在观察期内并发症发生率没有明显变化。有必要进一步研究手术趋势及相关的长期疗效。
四级。
