title: Current Trends in Ulnar Collateral Ligament Reconstruction Surgery Among Newly Trained Orthopaedic Surgeons.
abstract: BACKGROUND
  Ulnar collateral ligament (UCL) reconstructions are being performed with an increasing annual incidence. The purpose of this study was to evaluate trends in UCL surgery among recently trained orthopaedic surgeons.
  
  
  METHODS
  The American Board of Orthopaedic Surgeons (ABOS) database was used to identify all UCL reconstructions from 2004 to 2013. Procedures were identified by Current Procedural Terminology (CPT) codes and verified by International Classification of Disease, Ninth Revision (ICD-9) codes. Data on surgeon fellowship, practice location, concomitant surgical procedures, and complications were collected.
  
  
  RESULTS
  One hundred sixty-four UCL reconstructions were performed by 133 ABOS Part II candidates. The annual incidence increased from 1.52 to 3.46 cases per 10,000 (P = 0.042). Reconstructions were most commonly performed by surgeons with fellowship training in sports medicine (65.9%), hand and upper extremity (18.9%), and shoulder and elbow (9.1%). Most reconstructions were performed in isolation (57.3%), or with ulnar nerve transposition (32.9%) or elbow arthroscopy (9.8%). Concomitant elbow arthroscopy rates decreased significantly (P = 0.022). Complications occurred in 9.8% of cases, although the rates did not significantly change (P = 0.466).
  
  
  CONCLUSIONS
  UCL reconstructions are being performed with increasing frequency. Concomitant procedure rates remained the same, although arthroscopy was less commonly performed. Complication rates did not change considerably over the observed period. Further study of the surgical trends and associated long-term outcomes is warranted.
  
  
  METHODS
  Level IV.
authors.affiliation: From the Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, NY.
authors.forename: Ryan M
authors.initials: RM
authors.lastname: Degen
authors.forename: Christopher L
authors.initials: CL
authors.lastname: Camp
authors.forename: Johnathan A
authors.initials: JA
authors.lastname: Bernard
authors.forename: David M
authors.initials: DM
authors.lastname: Dines
authors.forename: David W
authors.initials: DW
authors.lastname: Altchek
authors.forename: Joshua S
authors.initials: JS
authors.lastname: Dines
mesh_terms: D000328:Adult; D016208:Databases, Factual; D004503:Education, Medical, Graduate; D005257:Fellowships and Scholarships; D005260:Female; D006801:Humans; D008297:Male; D000072161:Orthopedic Surgeons / Q000193:education / Q000639:trends*; D011183:Postoperative Complications / Q000453:epidemiology; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data / Q000639:trends*; D012189:Retrospective Studies; D000070638:Ulnar Collateral Ligament Reconstruction / Q000706:statistics & numerical data* / Q000639:trends; D014481:United States