Danilkowicz Richard M, O'Connell Robert S, Satalich James, O'Donnell Jeffrey A, Flamant Etienne, Vap Alexander R
Department of Orthopaedic Surgery, Duke University, Durham, North Carolina.
Department of Orthopaedic Surgery, Virginia Commonwealth University, Richmond, Virginia, U.S.A.
Arthrosc Sports Med Rehabil. 2021 Apr 15;3(2):e527-e533. doi: 10.1016/j.asmr.2020.12.004. eCollection 2021 Apr.
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.
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 tests were used to determine differences between group proportion categorical variables. Significance was considered at a ≤ .05.
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 ( < .01). Male patients had a greater incidence of MUCL injury, and a greater incidence of MUCL repair per 100,000 persons compared to females ( < .01).
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.
IV, Therapeutic Case Series.
评估当前全国范围内肘关节内侧尺侧副韧带（MUCL）修复的发生率，并描述接受修复患者的人口统计学特征。
利用Pearl Diver技术对2007年至2017年的全国私人保险数据库进行回顾性研究和分析。纳入所有诊断为MUCL损伤且接受修复的患者，使用临床修正码和当前操作术语编码24345，参考肘部尺侧副韧带的局部组织修复。提取的数据包括手术时患者的年龄、性别、种族、地区、手术年份、保险类型、医院环境以及修复手术90天内的任何相关诊断。采用标准描述性方法对研究样本进行特征分析，以计算频数和百分比。计算并报告连续变量的均值及其标准差和/或标准误以及95%置信区间，分类变量则报告频数和百分比。使用Pearson χ检验确定组间比例分类变量的差异。显著性水平设定为≤0.05。
2007年至2014年，数据库人群中每10万人的MUCL损伤发生率呈上升趋势，从4.59升至7.19（增长56%）。相应地，MUCL修复的发生率从0.016升至0.49（增长2962%）。然而，2015年至2017年这两个类别均有所下降，损伤发生率从7.19降至1.48，修复率从0.49降至0.012。接受修复的年龄在15至24岁人群中出现显著峰值。MUCL修复发生率在西部和南部最高（P<0.01）。男性患者的MUCL损伤发生率更高，每10万人的MUCL修复发生率也高于女性（P<0.01）。
在特定适应症中，MUCL修复已成为重建的可行替代方案。这种变化的推动因素可能是为了更快恢复运动且减少并发症，这主要归功于近期MUCL修复手术技术的改进。正如预期的那样，根据本研究使用的数据库，2007年至2014年美国MUCL修复的发生率稳步上升，随后在2017年出现相对难以解释的下降。15至24岁的年轻运动员年龄组的修复发生率显著最高。
IV，治疗性病例系列。
