Epidemiology of MUCL Repair and Reconstruction: A 5-Year Study in New York State

Lt Matthew A Zinner; Brian D Greenstein; Katherine Kachkarov; Michael J Meade; Eric V Neufeld; William Degouveia; Steven E Rokito

doi:10.1177/23259671251371285

Epidemiology of MUCL Repair and Reconstruction: A 5-Year Study in New York State

Orthop J Sports Med. 2025 Oct 15;13(10):23259671251371285. doi: 10.1177/23259671251371285. eCollection 2025 Oct.

Authors

Lt Matthew A Zinner¹, Brian D Greenstein², Katherine Kachkarov², Michael J Meade¹, Eric V Neufeld¹, William Degouveia¹, Steven E Rokito¹

Affiliations

¹ Northwell Health, Long Island Jewish Medical Center, New Hyde Park, New York, USA.
² Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA.

Abstract

Background: The incidence of medial ulnar collateral ligament (MUCL) reconstruction has increased significantly over the past 2 decades, especially in professional baseball. While new literature has demonstrated that MUCL repair is a viable alternative in the correct patient population with the potential for faster return to play, there have been no recent population-based studies comparing the incidence of the 2 procedures to determine how widespread the adoption of MUCL repair has become.

Purpose/hypothesis: The purpose of this study is to examine the epidemiological trends of MUCL repair compared with reconstruction on a statewide level over a 5-year period. The primary outcomes were the annual rates of MUCL repair and reconstruction. Secondary outcomes included patient demographics, institutional and surgeon volumes, and concomitant ulnar nerve transposition.

Study design: Descriptive epidemiological study.

Methods: The New York Statewide Planning and Research Cooperative System database was queried for all MUCL repairs and reconstructions in New York State from 2017 to 2021 utilizing outpatient Current Procedural Terminology, 4th Revision codes. Data obtained included concomitant ulnar nerve surgery, patient age, sex, ethnicity, insurance, and laterality, as well as institutional and surgeon volume.

Results: From 2017 to 2021, there were 745 MUCL surgeries performed in New York State: 242 repairs and 503 reconstructions. The incidence of MUCL repairs increased by 133% while reconstructions increased by 48% during this time period. Patients ≤16 years of age underwent MUCL repair at a significantly higher rate than college-aged patients between 19 and 22 years of age (40.9% vs 21.9%; P < .001). Female patients underwent repair at a rate 2.88 times higher than male patients. There was no difference in the type of surgery between patients with private or public insurance.

Conclusion: The overall rate of MUCL surgery has increased significantly over recent years. With advances in surgical technique and technology demonstrating the potential for faster return to play, MUCL repairs have continued to grow in popularity. This trend is most evident among teenage patients.

Keywords: baseball/softball; elbow; epidemiology; general sports trauma; medial ulnar collateral ligament; medical aspects of sports.