title: The epidemiology and health care burden of tennis elbow: a population-based study.
abstract: BACKGROUND
  Lateral elbow tendinosis (epicondylitis) is a common condition both in primary care and specialty clinics.
  
  
  OBJECTIVE
  To evaluate the natural history (ie, incidence, recurrence, and progression to surgery) of lateral elbow tendinosis in a large population.
  
  
  METHODS
  Descriptive epidemiology study.
  
  
  METHODS
  The study population comprised a population-based incidence cohort of patients with new-onset lateral elbow tendinosis between January 1, 2000, and December 31, 2012. The medical records of a 10% random sample (n=576) were reviewed to ascertain information on patient and disease characteristics, treatment modalities, recurrence, and progression to surgery. Age- and sex-specific incidence rates were calculated and adjusted to the 2010 US population.
  
  
  RESULTS
  The age- and sex-adjusted annual incidence of lateral elbow tendinosis decreased significantly over time from 4.5 per 1000 people in 2000 to 2.4 per 1000 in 2012 (P<.001). The recurrence rate within 2 years was 8.5% and remained constant over time. The proportion of surgically treated cases within 2 years of diagnosis tripled over time, from 1.1% during the 2000-2002 time period to 3.2% after 2009 (P<.00001). About 1 in 10 patients with persistent symptoms at 6 months required surgery.
  
  
  CONCLUSIONS
  The decrease in incidence of lateral elbow tendinosis may represent changes in diagnosis patterns or a true decrease in disease incidence. Natural history data can be used to help guide patients and providers in determining the most appropriate course at a given time in the disease process. The study data suggest that patients without resolution after 6 months of onset may have a prolonged disease course and may need surgical intervention.
authors: Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA sanders.thomas@mayo.edu.
authors: Thomas L
authors: TL
authors: Sanders
authors: Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA.
authors: Hilal
authors: H
authors: Maradit Kremers
authors: Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
authors: Andrew J
authors: AJ
authors: Bryan
authors: Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA.
authors: Jeanine E
authors: JE
authors: Ransom
authors: Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota, USA.
authors: Jay
authors: J
authors: Smith
authors: Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
authors: Bernard F
authors: BF
authors: Morrey
mesh_terms: D000328:Adult; D017281:Cost of Illness; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D052256:Tendinopathy / Q000453:epidemiology* / Q000601:surgery; D013716:Tennis Elbow / Q000453:epidemiology* / Q000601:surgery; D013997:Time Factors
keywords: incidence; lateral elbow tendinosis; lateral epicondylitis; recurrence; tennis elbow
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