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EPIDEMIOLOGY AND THE HEALTHCARE BURDEN OF TENNIS ELBOW: A POPULATION-BASED STUDY

Abstract

Lateral elbow tendinosis (epicondylitis) is a common condition both in primary care and specialty clinics. PURPOSE: The goal of this study was to evaluate the natural history (i.e., incidence, recurrence and progression to surgery) of lateral elbow tendinosis in a large population. METHODS: The study population comprised a population-based incidence cohort of patients with new-onset lateral elbow tendinosis between 1/1/2000 and 12/31/2012. 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 United States population. RESULTS: The age- and sex-adjusted annual incidence of lateral elbow tendinosis decreased significantly over time from 4.5 in 2000 to 2.4 per 1000 in 2012 (p<0.001). 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 doubled over time from 1.1% during 2000-2002 time period to 3.2% after 2009 (p<0.00001). About 1 in 10 patients with persistent symptoms at 6 months required surgery. CONCLUSION: 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. Our data suggest that those without symptom resolution after 6 months of onset may have a prolonged disease course and may need surgical intervention.

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