Disease Burden of Medial Epicondylitis in the USA is Increasing: An Analysis of 19,856 Patients from 2007 to 2014

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.