All right, thank you so much for staying with us today, and thank you to Anna for having me here today. I'd like to take a moment to acknowledge my coauthors, and we have no disclosures to report. Ulnar collateral ligament injuries are frequently treated surgically after trial of conservative measures utilizing the ulnar collateral ligament reconstruction and or repair procedures. Most published literature of ulnar collateral ligament injuries have focused on professional athletes and MLB players, whereas there is a paucity of literature focusing on younger athletes undergoing ulnar collateral ligament surgeries. Interestingly, the majority of ulnar collateral ligament surgeries are performed in collegiate and younger athletes, and ulnar collateral ligament repair was uncommon until the past decade. In the last three to five years, ulnar collateral ligament repair has been advocated for proximal distal avulsion injuries of the ulnar collateral ligament in younger athletes. The objectives of this study were to identify the geographic distribution and procedure settings for ulnar collateral ligament repair and ulnar collateral ligament reconstruction procedures, to identify rates of ulnar collateral ligament reconstruction and repair by year, and to assess rates of ulnar collateral ligament reconstruction and repair by age groups 15 to 19, 20 to 29, and 30 to 49, as well as to identify factors associated with ulnar collateral ligament reconstruction procedures. This was a retrospective cohort analysis performed utilizing the Humana Claims Database accessed through the Pearl Diver Research Program, which contains over 25 million de-identified patient claims records from beneficiaries across the United States. The inclusion criteria for this study assessed the years 2007 to 2016, utilizing CPT codes for ulnar collateral ligament repair and ulnar collateral ligament reconstruction. We excluded patients less than 15 years, greater than 49 years, and patients undergoing both the ulnar collateral ligament reconstruction and repair procedures concomitantly. Analysis were performed by year specifically assessing 2007 to 2011 versus 2012 to 2016 by age groups 15 to 19, 20 to 29, and 30 to 49, as well as by sex, with incidence rates calculated by dividing the number of procedures performed per 100,000 individuals. Statistical analysis were conducted, specifically pulse ulnar regression analysis, to calculate the incidence risk ratio for ulnar collateral ligament repair and reconstruction, respectively. Our results demonstrated that males more often underwent ulnar collateral ligament reconstruction, and that males ages 30 to 49 preferentially underwent ulnar collateral ligament repair. Both procedure types were more common in the South, specifically at hospital outpatient and ambulatory surgical centers. Specifically for 15 to 19-year-olds, ulnar collateral ligament reconstructions were performed at a rate of 16.33 procedures per 100,000 versus 3.88 procedures for ulnar collateral ligament repairs in the same age group. Similarly in this age group, ulnar collateral ligament repairs did increase significantly. However, strikingly, ulnar collateral ligament reconstructions are preferentially performed for 15 to 19-year-olds with an incidence risk ratio greater than 28. Similarly, for 20 to 29-year-olds, ulnar collateral ligament reconstructions are preferentially performed with an incidence risk ratio of 3.8. For 15 to 19-year-olds in this data set, they were 8.4 times more likely to undergo ulnar collateral ligament reconstruction versus repair, and males were 4.6 times more likely than females to undergo ulnar collateral ligament reconstruction versus repair. Limitations of the study include the utilization of de-identified data from an insurance claims data set, which is subject to accurate coding, as well as large reference populations, which may have depressed rates of ulnar collateral ligament repair and reconstruction, as well as prevented values from reaching significance. Values less than 11 could not be shown as per Humana. Additionally, recent advances in techniques in ulnar collateral ligament repair may not have been reflected in the current data set, and we did not have a valuable for analysis indications for surgery or athletic statuses of these patients. In conclusion, ulnar collateral ligament repairs are increasing, specifically in older patients and females, and for males ages 15 to 19, they're preferentially undergoing the ulnar collateral ligament reconstruction procedure. The ulnar collateral ligament reconstruction procedure still appears to be the gold standard treatment for young, active male athletes. Thank you so much for having me today.

ulnar collateral ligament injuries

surgical treatments

younger athletes

ulnar collateral ligament reconstruction

retrospective cohort analysis