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Medial Epicondylitis: Patient Demographics, Comorbidities, Setting of Diagnosis, and Reported Diagnosis and Surgical Trends Within a Large Insurance Database
Andrew Ardeljan, B.S.^1,2, Joseph Palmer, D.O.³, Rushabh M Vakharia, M.D.¹, Michael O Madden, D.O.⁴ and Martin W Roche, M.D.¹, (1)Holy Cross Orthopedic Institute, Ft. Lauderdale, FL, (2)NSU College of Osteopathic Medicine, Davie, FL, (3)Broward General Medical Center, Ft. Lauderdale, FL, (4)University of Minnesota, Minneapolis, MN

Abstract

INTRODUCTION: Medial epicondylitis (ME), or golfer’s elbow, is a relatively uncommon musculoskeletal pathology that effects the common flexor tendon in the forearm. As a result, most of the literature analyzing epicondylitis of the forearm focuses on lateral epicondylitis (tennis elbow). Therefore, the aim of this study was to analyze: (1) demographics, (2) comorbidities, (3) initial setting of diagnosis, and (4) reported diagnosis and surgical trends in patients with ME.

METHODS: A Humana patient-population consisting of 8 million lives was retrospectively analyzed from 2007 to 2015 using International Classification of Disease, 9^th Revision (ICD-9) and 10^th Revision (ICD-10) codes. Patients with ME were identified using ICD-9 code: 726.31, and ICD-10 code: M7700. Patients undergoing surgical intervention were identified using CPT codes 24358 and 24359. Patients with lateral epicondylitis were excluded using the exclusion filter command. The query yielded a total of 23,573 patients. Primary trends analyzed included: demographics, comorbidities, initial setting of diagnosis, and reported diagnosis and surgical trends. Patient records were deidentified and the study was exempt from IRB Approval.  

RESULTS: ME was most common in patients aged 60 – 69, followed by age groups 50 – 59, and 40 – 49. Males had higher incidence of ME than females. (Table 1.) Comorbidities with greatest incidence were hypertension and hyperlipidemia, followed by diabetes mellitus and tobacco use. Tobacco use was significantly higher in patients with ME who underwent surgical intervention (p=0.009). (Table 2.) Most patients with ME were diagnosed in physician’s offices, followed by outpatient hospitals, and urgent care facilities. Diagnoses of ME and subsequent surgical intervention have increased substantially from 2007 to 2015. (Figure 1.)

CONCLUSION: Our study aims to help clinicians better understand characteristics among patients with medial epicondylitis. Our results demonstrate that a significant number of patients with ME are also diagnosed with comorbidities and those who undergo surgical intervention have higher rates of tobacco use. Furthermore, our results show an increase in diagnosis of ME and subsequent surgical intervention from 2007 to 2015.