Trends in Ulnar Collateral Ligament Injuries and Surgery From 2010 to 2019: An Analysis of a National Medical Claims Database

Overview

Journal Orthop J Sports Med

Specialty Orthopedics

Date 2024 Nov 21

PMID 39569412

Authors

Matthew J Solomito

Regina O Kostyun

Joshua T Sabitsky

Carl W Nissen

Affiliations

Soon will be listed here.

Abstract

Background: Ulnar collateral ligament (UCL) injuries have been on the rise for the past 3 decades. Current epidemiological studies on the incidence of UCL injuries have been limited to state or regional data.

Purpose: To utilize a large national claims database to determine the rates of UCL injuries and UCL surgical procedures over the past decade (2010-2019) and whether there has been a change in UCL surgical procedure patterns in the United States.

Study Design: Descriptive epidemiology study.

Methods: The PearlDiver patient claims database was used to identify UCL injuries occurring from 2010 and 2019 that were sustained by male patients between 10 and 34 years of age. The study cohort was divided into 5 age groups (10-14, 15-19, 20-24, 25-29, and 30-34 years). Primary outcomes included the number of patients in each age group who sustained a UCL injury, the number of patients in each age group who underwent surgery, and the mean time from injury to surgery.

Results: A total of 19,348 UCL injuries occurred between 2010 and 2019, and 13% required a surgical intervention. Most of the injuries (54%) occurred in the 15- to 19-year group. Patients in the 20- to 24-year group were more likely to undergo surgery versus the 15- to 19-year group. Results demonstrated a trend toward delayed surgical interventions in patients in the 20- to 24-year group in the latter part of the decade.

Conclusion: Data suggested that male patients <20 years account for the majority of UCL injuries, while male patients aged between 20 and 24 years are most likely to undergo surgery. Despite a number of targeted injury-prevention strategies and rule changes in sports, the UCL injury rate remained high. Therefore, there is a clear and present need to continue to develop UCL injury-prevention strategies for the younger population.

References

Atanda Jr A, Averill L, Wallace M, Niiler T, Nazarian L, Ciccotti M . Factors Related to Increased Ulnar Collateral Ligament Thickness on Stress Sonography of the Elbow in Asymptomatic Youth and Adolescent Baseball Pitchers. Am J Sports Med. 2016; 44(12):3179-3187. DOI: 10.1177/0363546516661010. View

Holt J, Pedowitz J, Stearns P, Bastrom T, Dennis M, Dwek J . Progressive Elbow Magnetic Resonance Imaging Abnormalities in Little League Baseball Players Are Common: A 3-Year Longitudinal Evaluation. Am J Sports Med. 2019; 48(2):466-472. DOI: 10.1177/0363546519888647. View

Li N, Goodman A, Lemme N, Owens B . Epidemiology of Elbow Ulnar Collateral Ligament Injuries in Throwing Versus Contact Athletes of the National Collegiate Athletic Association: Analysis of the 2009-2010 to 2013-2014 Seasons. Orthop J Sports Med. 2019; 7(4):2325967119836428. PMC: 6457031. DOI: 10.1177/2325967119836428. View

Solomito M, Garibay E, Ounpuu S, Tate J, Nissen C . A Biomechanical Evaluation of the Kinetics for Multiple Pitching Techniques in College-Aged Pitchers. Orthop J Sports Med. 2015; 1(5):2325967113508255. PMC: 4555497. DOI: 10.1177/2325967113508255. View

Werner S, Fleisig G, Dillman C, Andrews J . Biomechanics of the elbow during baseball pitching. J Orthop Sports Phys Ther. 1993; 17(6):274-8. DOI: 10.2519/jospt.1993.17.6.274. View

Erickson B, Nwachukwu B, Rosas S, Schairer W, McCormick F, Bach Jr B . Trends in Medial Ulnar Collateral Ligament Reconstruction in the United States: A Retrospective Review of a Large Private-Payer Database From 2007 to 2011. Am J Sports Med. 2015; 43(7):1770-4. DOI: 10.1177/0363546515580304. View

Goodrich E, Cox B, Plummer H, Cohen A, Andrews J, Saper M . Adolescent Baseball Pitchers With Ulnar Collateral Ligament Tears Exhibit a High Proportion of Partial Tears. Am J Sports Med. 2022; 50(8):2198-2202. DOI: 10.1177/03635465221094326. View

Ifarraguerri A, Berk A, Rao A, Trofa D, Ahmad C, Martin A . A systematic review of the outcomes of partial ulnar collateral ligament tears of the elbow in athletes treated non-operatively with platelet-rich plasma injection. Shoulder Elbow. 2024; 16(4):413-428. PMC: 11418690. DOI: 10.1177/17585732241235631. View

Conte S, Camp C, Dines J . Injury Trends in Major League Baseball Over 18 Seasons: 1998-2015. Am J Orthop (Belle Mead NJ). 2016; 45(3):116-23. View

10.

Pytiak A, Kraeutler M, Currie D, McCarty E, Comstock R . An Epidemiological Comparison of Elbow Injuries Among United States High School Baseball and Softball Players, 2005-2006 Through 2014-2015. Sports Health. 2017; 10(2):119-124. PMC: 5857729. DOI: 10.1177/1941738117736493. View

11.

Rothermich M, Fleisig G, Conte S, Hart K, Cain Jr E, Dugas J . Short-Term Trends in Elbow Ulnar Collateral Ligament Surgery in Collegiate Baseball Players: An Analysis of 25,587 Player-Years. Orthop J Sports Med. 2021; 9(7):23259671211016846. PMC: 8330484. DOI: 10.1177/23259671211016846. View

12.

Erickson B, Harris J, Chalmers P, Bach Jr B, Verma N, Bush-Joseph C . Ulnar Collateral Ligament Reconstruction: Anatomy, Indications, Techniques, and Outcomes. Sports Health. 2015; 7(6):511-7. PMC: 4622381. DOI: 10.1177/1941738115607208. View

13.

Fleisig G, Andrews J, Dillman C, ESCAMILLA R . Kinetics of baseball pitching with implications about injury mechanisms. Am J Sports Med. 1995; 23(2):233-9. DOI: 10.1177/036354659502300218. View

14.

Olsen 2nd S, Fleisig G, Dun S, Loftice J, Andrews J . Risk factors for shoulder and elbow injuries in adolescent baseball pitchers. Am J Sports Med. 2006; 34(6):905-12. DOI: 10.1177/0363546505284188. View

15.

Zaremski J, Vincent K, Vincent H . Elbow Ulnar Collateral Ligament: Injury, Treatment Options, and Recovery in Overhead Throwing Athletes. Curr Sports Med Rep. 2019; 18(9):338-345. DOI: 10.1249/JSR.0000000000000629. View

16.

Chauhan A, McQueen P, Chalmers P, Ciccotti M, Camp C, DAngelo J . Nonoperative Treatment of Elbow Ulnar Collateral Ligament Injuries With and Without Platelet-Rich Plasma in Professional Baseball Players: A Comparative and Matched Cohort Analysis. Am J Sports Med. 2019; 47(13):3107-3119. DOI: 10.1177/0363546519876305. View

17.

Atanda Jr A, Buckley P, Hammoud S, Cohen S, Nazarian L, Ciccotti M . Early Anatomic Changes of the Ulnar Collateral Ligament Identified by Stress Ultrasound of the Elbow in Young Professional Baseball Pitchers. Am J Sports Med. 2015; 43(12):2943-9. DOI: 10.1177/0363546515605042. View

18.

Baron J, Westermann R, DeMik D, An Q, Wolf B . Trends in Medial Ulnar Collateral Ligament Repair and Reconstruction From 2007 to 2016: A Population-Based Study of a Large Private Insurance Database. HSS J. 2022; 18(1):116-121. PMC: 8753544. DOI: 10.1177/1556331621997810. View

19.

Idowu O, Boyajian H, Lindsay-Rivera K, Lee C, Lee M, Shi L . Trends of Ulnar Collateral Ligament Reconstruction in the United States from 2003 to 2014: Analysis of 3,133 Patients. Arthrosc Sports Med Rehabil. 2020; 2(6):e705-e710. PMC: 7754523. DOI: 10.1016/j.asmr.2020.05.005. View

20.

Mills 4th F, Misra A, Goyeneche N, Hackel J, Andrews J, Joyner P . Return to Play After Platelet-Rich Plasma Injection for Elbow UCL Injury: Outcomes Based on Injury Severity. Orthop J Sports Med. 2021; 9(3):2325967121991135. PMC: 7983438. DOI: 10.1177/2325967121991135. View