Abstract
Background
Medial epicondylitis (ME), or “golfer’s elbow,” is often treated initially by conservative means. Up to 15% of recalcitrant cases require surgical intervention, according to small sample populations, but no national study has determined the incidence of the diagnosis or corroborated the rate of surgical intervention.
Purpose/Question
We sought to review the annual incidence of ME, surgical rates, and health care costs in a population setting.
Methods
A national database was queried for ME from 2007 to 2014. Annual rates and the percentage of diagnosed cases subjected to surgical intervention were recorded. Epidemiologic data was reported with descriptive statistics, and the significant trends over time were analyzed using linear regression.
Results
We identified 19,856 cases of ME in the study period. There was a significant increase in the annual incidence and overall incidence per 10,000 patients. The proportion of diagnoses in patients under 65 years of age decreased significantly, while the proportion in those 65 years of age or older significantly increased. The annual number of surgical interventions significantly increased over the study period, although the annual proportion of diagnosed cases proceeding to surgery remained constant. The proportion of patients 65 years of age or older undergoing surgery significantly increased. Total reimbursement for the management of ME during the study period was $1,877,189. While there was a significant increase in the total annual reimbursement, annual per-patient reimbursement did not change significantly.
Conclusions
While the annual incidence of ME and surgical treatment of ME increased significantly from 2007 to 2014, the proportion of cases treated surgically did not. Notably, the proportion of patients 65 years of age or older diagnosed with and being surgically treated for ME has increased in recent years. Total reimbursement for ME has steadily risen, although per-patient reimbursement rates have not significantly changed.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Amin NH, Kumar NS, Schickendantz MS. Medial epicondylitis: evaluation and management. J Am Acad Orthop Surg. 2015;23(6):348–355.
Ciccotti MC, Schwartz MA, Ciccotti MG. Diagnosis and treatment of medial epicondylitis of the elbow. Clin Sports Med. 2004;23(4):693–705.
Degen RM, Cancienne JM, Camp CL, Altchek DW, Dines JS, Werner BC. Patient-related risk factors for requiring surgical intervention following a failed injection for the treatment of medial and lateral epicondylitis. Phys Sportsmed. 2017;45(4):433–437.
Descatha A, Leclerc A, Chastang JF, Roquelaure Y. Medial epicondylitis in occupational settings: prevalence, incidence and associated risk factors. J Occup Environ Med. 2003;45(9):993–1001.
Grawe BM, Fabricant PD, Chin CS, et al. Clinical outcomes after suture anchor repair of recalcitrant medial epicondylitis. Orthopedics. 2015;39(1):e104–107.
Jobe FW, Ciccotti MG. Lateral and medial epicondylitis of the elbow. J Am Acad Orthop Surg. 1994;2(1):1–8.
Ritz B. Humeral epicondylitis among gas- and waterworks employees. Scand J Work Environ Health. 1995;21(6):478–486.
Shiri R, Viikari-Juntura E. Lateral and medial epicondylitis: Role of occupational factors. Best Pract Res Clin Rheumatol. 2011;25(1):43–57.
Shiri R, Viikari-Juntura E, Varonen H, Heliovaara M. Prevalence and determinants of lateral and medial epicondylitis: a population study. Am J Epidemiol. 2006;164(11):1065–1074.
Silverstein B, Welp E, Nelson N, Kalat J. Claims incidence of work-related disorders of the upper extremities: Washington state, 1987 through 1995. Am J Public Health. 1998;88(12):1827–1833.
Solheim E, Hegna J, Øyen J, Inderhaug E. Arthroscopic treatment of lateral epicondylitis: tenotomy versus debridement. Arthroscopy. 2016;32(4):578–585.
Taylor SA, Hannafin JA. Evaluation and management of elbow tendinopathy. Sports Health. 2012;4(5):384–393.
Vinod AV, Ross G. An effective approach to diagnosis and surgical repair of refractory medial epicondylitis. J Shoulder Elbow Surg.2015;24(8):1172–1177.
Walker-Bone K, Palmer KT, Reading I, Coggon D, Cooper C. Occupation and epicondylitis: a population-based study. Rheumatology. 2011;51(2):305–310.
Wolf JM, Mountcastle S, Burks R, Sturdivant RX, Owens BD. Epidemiology of lateral and medial epicondylitis in a military population. Mil Med. 2010;175(5):336–339.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
Anthony Wiggins, BA, Jourdan M. Cancienne, MD, Christopher L. Camp, MD, Ryan M. Degen, MD, David W. Altcheck, MD, and Brian C. Werner, MD, declare that they have no conflict of interest. Joshua S. Dines, MD, reports receiving grants and personal fees from Arthrex, personal fees and royalties from Linvatec, and royalties from Wolters Kluwer Health; acting as a paid consultant to Trice; holding editorial or governing board membership at American Journal of Orthopedics and Journal of Shoulder and Elbow Surgery and board or committee membership at American Shoulder and Elbow Surgeons, all outside the submitted work.
Human/Animal Rights
N/A
Informed Consent
N/A
Required Author Forms
Disclosure forms provided by the authors are available with the online version of this article.
Rights and permissions
About this article
Cite this article
Wiggins, A.J., Cancienne, J.M., Camp, C.L. et al. Disease Burden of Medial Epicondylitis in the USA Is Increasing: An Analysis of 19,856 Patients From 2007 to 2014. HSS Jrnl 14, 233–237 (2018). https://doi.org/10.1007/s11420-018-9617-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11420-018-9617-5