Epidemiology of Medial Ulnar Collateral Ligament Reconstruction: A 10-Year Study in New York State.
Level 4 - case-series / case-control
Retrospective descriptive epidemiological study of administrative discharge data without a comparator group
PubMed 26797699 · doi:10.1177/0363546515622407
What was done
Descriptive epidemiological study analyzing ambulatory discharge records from the New York Statewide Planning and Research Cooperative System (SPARCS) database from 2002 to 2011. The authors identified all medial ulnar collateral ligament (UCL) reconstructions using outpatient CPT-4 codes to assess yearly incidence rates, patient demographics (age, sex, ethnicity, insurance), hospital volumes, and concurrent ulnar nerve procedures.
What was found
UCL reconstructions in New York State increased significantly from 2002 to 2011 (P < .001). Total surgical volume rose by 193%, and the population incidence rate tripled from 0.15 to 0.45 per 100,000. Mean patient age was 21.6 ± 8.89 years, with significant growth in patients aged 17–18 and 19–20 years (P < .001). Males were 11.8 times more likely to receive surgery than females (P < .001), and privately insured individuals were 25 times more likely than Medicaid recipients (P = .0014). Concomitant ulnar nerve release or transposition increased by 400% over the 10-year period (P < .001).
Why it matters
This study provides population-level confirmation that UCL reconstruction rates rose dramatically over a decade, heavily driven by late-adolescent male athletes and accompanied by a sharp rise in concomitant ulnar nerve surgeries.
Limits
The abstract does not report the total absolute number of surgeries (n). The analysis is limited to a single state and relies on administrative billing codes, lacking clinical variables such as sport type, level of play, pitch counts, exact injury mechanisms, or long-term clinical outcomes.
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