Disproportionate trends in ulnar collateral ligament reconstruction: projections through 2025 and a literature review.
Level 3 - non-randomized controlled study
Retrospective population-based registry cohort and projection analysis
PubMed 27197888 · doi:10.1016/j.jse.2016.02.036
What was done
A retrospective registry analysis of New York State's Statewide Planning and Research Cooperative System (SPARCS) database was performed for patients aged 10 to 40 years undergoing medial ulnar collateral ligament reconstruction (UCLR) between 2003 and 2014. Poisson regression was used to calculate historical population incidence per 100,000 people and to model projected UCLR trends through 2025 alongside a narrative literature review of adolescent outcomes.
What was found
A total of 890 patients underwent UCLR in New York State between 2003 and 2014, with total annual procedures increasing by 343% over the study period. The average annual incidence was highest in the 15- to 19-year-old cohort at 6.3 ± 2.8 per 100,000 people, which was significantly greater than all other age groups (P < .001). Projections through 2025 suggested that incidence in 15- to 19-year-olds and 20- to 24-year-olds would continue to rapidly increase, whereas rates in other age groups would remain stable.
Why it matters
This study documents that the increase in elbow UCL reconstruction is driven primarily by adolescents and young adults, underscoring the need for injury prevention strategies in youth throwing sports.
Limits
The analysis is restricted to administrative billing data from a single state, lacking clinical details such as sport played, pitch counts, exact anatomical pathology, or surgical outcomes. Future projections past 2014 rely on mathematical modeling and may not account for subsequent changes in clinical guidelines, coaching practices, or injury prevention programs.
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