Background:A variety of agents are used during rotator cuff repair (RCR) to establish biophysical barriers against adhesion formation, including sodium hyaluronate and poloxamer. The aim of this study was to determine the role played by injection location and analyze the effects on shoulder function after cuff repair. Methods:We retrospectively reviewed data from 187 consecutive patients with rotator cuff tears who were treated with a thermosensitive medical chitosan-based anti-adhesive agent. The 45 patients in the glenohumeral joint (GH) group were matched 1:1 with patients in the subacromial space (SA) group based on propensity scores. Clinical outcomes and range of motion (ROM) were evaluated using a visual analog scale (VAS) score for pain and functional assessments conducted preoperatively, 6 months postoperatively, and at the final follow-up (minimum 12 months). Results:After excluding patients without 1 year of postoperative follow-up, 28 patients in each group were chosen for this study. The preoperative VAS score for pain, functional scores, and ROM did not differ significantly between the groups. At the final visit, the VAS score for pain was statistically significantly lower in the SA group (1.04±0.69 for GH group vs. 0.78±1.21 for SA group, P=0.038), but the difference did not meet the criteria for the minimal clinically important difference (MCID). Furthermore, none of the functional scores or ROMs differed significantly between the groups at the final visit. There were two retears in the GH group (7.1%) and three retears in the SA group (10.7%). Conclusions:Neither ROM nor the retear rate differed between glenohumeral and subacromial injection of a thermosensitive medical chitosan-based anti-adhesive agent after RCR. Although the SA group had a slightly lower VAS score for pain at the last follow-up, the difference did not reach the MCID criteria. Overall, the injection site did not appear to alter postoperative ROM recovery. Level of evidence:III.

Background Postoperative rehabilitation and perioperative pain control after arthroscopic rotator cuff repair (ARCR) remain heterogeneous, and national practice patterns in South Korea are not well described. This study aimed to characterize contemporary rehabilitation and pain-control protocols among Korean shoulder surgeons, identify areas of majority consensus, and explore institutional differences. Methods A web-based questionnaire (postoperative rehabilitation and pain-control section of a 104-item survey; questions 69-104) was distributed to members of the Korean Arthroscopy Society (KAS) between August 1 and September 15, 2025. Responses were collected anonymously via Google Forms. Descriptive statistics were reported as counts and percentages. A response selected by ≥ 50% of respondents was considered a consensus statement. Subgroup analyses compared university hospitals (Group U) with non-university institutions (Group N). Results A total of 100 surgeons completed the survey (Group U, 40; Group N, 60). The most common immobilization device was an abduction brace (96.0%), most commonly positioned at approximately 30° of abduction (81.8%). Passive ROM (PROM) exercises were initiated within 1 week by 22.7% of respondents, whereas 77.3% initiated PROM at ≥2 weeks. Strengthening exercises were most commonly initiated at 12 weeks (59.6%). Return to sports or heavy shoulder-demanding work was most commonly permitted at ≥6 months (82.8%). Perioperative nerve blocks were performed routinely (almost all/most patients) by 68.7% of respondents, most commonly using an interscalene block (71.4%). Group U was less likely to initiate PROM within 1 week than non-university institutions (7.9% vs 32.2%, p = 0.011), more likely to allow return to sports/heavy work at ≥6 months (97.5% vs 72.9%, p = 0.004), and had a shorter length of stay (median 4 vs 7 days, p < 0.001). Conclusion Postoperative rehabilitation and pain-control strategies after ARCR in South Korea show both consensus and variability. Compared with previously published surveys, Korean respondents generally favored a delayed start of PROM, along with later strengthening and return-to-sport timelines.Level of Evidence IV (Cross-sectional survey)

Background Rotator cuff retears following arthroscopic rotator cuff repair (ARCR) remain a critical clinical challenge, influenced by patient, tear, and rehabilitation factors. Conventional assessment methods struggle to capture this multifactorial complexity, limiting accurate retear prediction and personalized management. The purpose of this study was to develop a machine learning-based predictive model to stratify the risk of structural retear at 6 months postoperatively. Methods This study analyzed 1,428 patients with complete datasets from an initial cohort of 3,090 patients who underwent ARCR between January 2011 and May 2024 across four centers. A total of 79 clinical variables were collected, including patient demographics, tear size, range of motion, muscle strength, and pain and functional scores at baseline and at 2–4 months postoperatively. Retear was defined as Sugaya classification type IV or V on standardized 6-month postoperative MRI. Five machine learning models (Logistic Regression, k-Nearest Neighbors, Support Vector Machine, Convolutional Neural Network, and Multi-Layer Perceptron) were evaluated for retear prediction. Model performance was evaluated using accuracy, precision, recall, F1-score, and area under the receiver operating characteristic curve (AUROC). Results The Multi-Layer Perceptron (MLP) model showed the most favorable numerical performance among the evaluated models, with a retear-class F1-score of 0.76 and precision of 0.92 under a random 80:20 split, and the largest AUROC among the models tested. However, under temporal validation the retear-class F1-score fell to 0.30, indicating limited generalizability over time. Conclusions The MLP model demonstrated potential for stratifying the risk of MRI-defined 6-month structural retear after ARCR and may serve as an adjunctive tool for early postoperative risk stratification. Because it relies on postoperative predictors and has been evaluated only within a single hospital network, external validation is required before clinical use. Level of Evidence Level II; Prognostic Study

Background:Despite advances in arthroscopic techniques and accumulating clinical evidence, the management of impingement symptoms without a definite rotator cuff tear and repairable rotator cuff tears remains variable in daily practice. Understanding contemporary practice patterns may help identify areas of consensus and variation and inform future guideline development. Methods:A nationwide, cross-sectional, web-based survey was conducted among members of the Korean Arthroscopy Society. The full questionnaire consisted of 110 items; the present study analyzed 37 items addressing impingement symptoms without a definite rotator cuff tear, acromioplasty during rotator cuff repair, management of concomitant long head of the biceps pathology, indications and techniques for partial-thickness tears, repair strategies for repairable full-thickness tears, and decision-making for subscapularis tears. Responses were summarized descriptively. Majority consensus was defined as selection by at least half of respondents. Subgroup analyses were performed according to practice setting, comparing university-based and non-university-based surgeons. Results:A total of 100 surgeons completed the survey. Most respondents reported that they rarely consider surgery for impingement symptoms without a definite rotator cuff tear and that escalation to surgery is primarily driven by persistent symptoms rather than imaging findings alone. During rotator cuff repair, acromioplasty was commonly performed, typically limited to spur excision. Management of long head of the biceps pathology showed strong consensus, with treatment decisions guided mainly by patient age and activity level and a preference for tenotomy in older patients. For partial-thickness rotator cuff tears, operative thresholds varied, particularly for lower-grade tears; however, when surgery was selected for partial articular-sided lesions, tear completion followed by repair was the most commonly preferred approach. Suture-bridge constructs were strongly favored for repairable full-thickness tears, with tear size, retraction, and tissue quality identified as the primary determinants of construct selection. Practice-setting differences were observed in the timing of escalation from conservative care and in the selective use of biologic adjuncts, including greater use of bioinductive patches for bursal-sided partial-thickness tears in university-based settings. Conclusion:This nationwide survey suggests that Korean shoulder surgeons have generally aligned their practice with contemporary evidence by avoiding routine surgery for impingement without a definite tear and by applying anatomy-driven strategies for repairable rotator cuff tears. Persistent variability in operative thresholds for partial-thickness tears and selective use of biologic adjuncts highlights areas where further evidence synthesis and consensus guidance may help reduce practice variation and support standardized, value-based care. Level of evidence:Level IV, Cross-sectional survey study.

Background:The optimal indications for superior capsular reconstruction (SCR) in cases of massive irreparable rotator cuff tears (RCTs) accompanied by degenerative arthritis remain controversial. Methods:A systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, searching PubMed, Embase (Elsevier), and Google Scholar. Studies were included if they documented Hamada grade and reported clinical and radiographic outcomes after SCR for irreparable RCTs. American Shoulder and Elbow Surgeons (ASES) score, visual analog scale for pain (pVAS), active range of motion, and acromiohumeral distance (AHD) were analyzed. Results:In all 7 studies, there was no consistent trend observed regarding the influence of arthritis on the improvement of ASES scores, and none of the studies showed statistically significant correlations (p > 0.05). All 5 studies regarding pVAS showed a trend that the pVAS improvement after surgery decreased as the severity of arthritis increased (beta coefficient < 0). Out of the 7 studies regarding forward flexion (FF), 6 demonstrated a trend where the improvement after surgery decreased as the severity of arthritis increased (beta coefficient < 0). There was a tendency for the improvement in AHD to increase as the Hamada grade progressed. Conclusions:There was no consistent trend observed regarding the impact of the severity of arthritis on the improvement of ASES score. However, there was a trend of decreasing improvement in pVAS and FF after surgery as arthritis progressed. SCR could be a viable option even in cases of Hamada grades 3 and 4.

Adding a fibular strut bone graft to locking plate fixation has been introduced to improve stability and prevent varus collapse. The purpose of this study was to perform finite element analysis (FEA) of the biomechanical characteristics of different insertion angles of the fibular strut graft in proximal humerus fractures. Proximal humerus fractures with metaphyseal comminution and instability were simulated by creating wedge-shaped osteotomies medially and laterally for varus and valgus models, respectively. Three-dimensional finite element models were reconstructed from computed tomography images. A locking compression plate with a length of 90 mm (three holes) was applied to the proximal humerus fracture model. Fibular allografts were inserted at 0° and 30° to the humeral shaft. Axial and traction forces of 70°, 90°, and 110° relative to the vertical axis were applied to each model to simulate stress on the plate and graft. At axial loads, stresses in both the plate and the graft were lower when the graft was inserted at 0° than at 30°. Under traction loads, plate stress was lower with 30° insertion. Graft stress was also lower with 30° in most experimental conditions in both the valgus and varus models. These findings suggest that oblique insertion may provide biomechanical advantages under traction forces in unstable proximal humerus fractures.

Biologic augmentation in arthroscopic rotator cuff repair has emerged as a key focus in the ongoing pursuit to enhance tendon healing and improve long-term outcomes. The recent randomized controlled trial of bovine bioinductive collagen implants in arthroscopic rotator cuff repair presents a significant reduction in retear rate. As biologic augmentation continues to evolve, future research should aim to define patient subgroups who are most likely to benefit from specific augmentation strategies, both biologically and economically. Moreover, we need an explanation as to what makes a bioinductive collagen implant produce better retear rate compared with other type of collagen implants.

Background and Objectives: Hook plate fixation has been widely used for unstable distal clavicle fractures, but concerns remain regarding implant-related complications and the need for secondary removal. Locking plate fixation with supplementary cerclage wiring has been proposed as an alternative that may provide stability while reducing complications. This study compared the clinical and radiologic outcomes of locking plate fixation with cerclage wiring versus hook plate fixation. Materials and Methods: A retrospective review was performed on patients who underwent open reduction and internal fixation for unstable distal clavicle fractures (Cho’s classification type II) between 2015 and 2024. Patients with at least 6 months of follow-up were included. Two techniques were evaluated: locking plate with cerclage wiring (Group 1) and hook plate fixation (Group 2). Clinical outcomes, including complications, range of motion, and patient satisfaction, were compared at the final follow-up. Results: A total of 52 patients met the inclusion criteria: 27 in Group 1 and 25 in Group 2. The overall mean follow-up period was 13.17 ± 8.46 months. The distribution of fracture types was not significantly different between groups (p = 0.287). Complications were more frequent in Group 2 (40%), including postoperative stiffness requiring capsular release (70%), nonunion requiring revision (20%), and peri-implant fracture (10%). The overall union rate was 100% in Group 1 and 80% in Group 2. In contrast, Group 1 had only one complication (3.7%), a peri-implant fracture (p = 0.002). Shoulder range of motion at the final follow-up showed no significant difference between groups. Conclusions: Hook plate fixation was associated with a significantly higher complication rate compared with locking plate fixation with cerclage wiring. Locking plate fixation with supplementary cerclage wiring appears to be a better surgical option for unstable distal clavicle fractures.

While arthroscopic rotator cuff repair is recognized as a standard treatment option, the risk of postoperative re-tear is a major concern. Purpose of this study was to evaluate the effect of porcine-derived absorbable patch-type atelocollagen during arthroscopic rotator cuff repair. Sixty-four patients who were diagnosed with rotator cuff tears by magnetic resonance imaging (MRI) were enrolled prospectively from November 2020 to December 2021. Both groups were performed using the suture bridge technique. For experimental group 1, before securing the lateral anchors, absorbable patch-type atelocollagen was inserted between the footprint and the tendon. On postoperative day 2, the patients underwent MRI to confirm containment of the patch-type atelocollagen. At postoperative 6 months and 1 year, the signal intensity (SI) of the repaired tendon was assessed on MRI. Patients were evaluated using the visual analog scale (VAS) for pain, range of motions (ROM), and shoulder function was evaluated by using American Shoulder and Elbow Surgeons Shoulder Assessment score (ASES), Constant score, University of California at Los Angeles (UCLA) shoulder score and Korean Shoulder Score (KSS) preoperatively and at 2, 3, 6 months and at 1 year follow-up visit. The patch-type atelocollagen was confirmed to be contained by the time 0 MRI was taken 2 days postoperatively. Twelve re-tear cases were recorded representing a 21.8% re-tear rate. A significantly low re-tear rate was found in group 1 as three cases were observed in group 1 (10.3%) and nine cases were observed in group 2 (34.6%) (p = .048). However, no significant changes in the pain or functional scores and ROM were observed between the groups 1 year postoperatively. The tendon healing rate after rotator cuff repair was significantly higher in the group who received absorbable patch-type atelocollagen than in the control group.

The evolution of shoulder arthroplasty has seen transformative advancements to improve precision, minimize complications, and optimize functional outcomes. Patient-specific instrumentation and navigation systems are pivotal innovations that improve surgical accuracy and enable tailored approaches for complex anatomy. These tools also impact preoperative planning and decision-making, contributing to more efficient procedures and reduced intraoperative errors. Emerging technologies, including augmented reality, virtual reality, and robotic surgery, introduce novel opportunities for preoperative visualization, intraoperative guidance, and interactive training. These technologies demonstrate significant potential for improving guidewire placement accuracy, providing real-time procedural assistance, and transforming orthopedic education through immersive and efficient training platforms. While promising, these innovations require further research to validate their long-term efficacy and establish standardized protocols for broader clinical adoption. This review highlights current advancements and challenges, emphasizing the capability of these technologies to enhance patient care and advance shoulder arthroplasty.

Concomitant long head of biceps (LHB) pathologies commonly occur with rotator cuff tears, but LHB problems are often underestimated. There is a lack of studies on the correlation between bicipital groove morphology and biceps pathology, as well as the significance of bony spurs around the groove. This study analyzed the anatomical parameters of the bicipital groove and spur formation using 3D-CT in 111 patients. Biceps spurs were evaluated using 3D and 2D-CT images, and patients were grouped by age (below and above 55 years). The detection rate of biceps spur was higher with 3D-CT (54.0%) than with 2D-CT (42.3%). Spur incidence was significantly greater in older patients (60.3% vs. 45.8%). The average groove width was narrower in older adults (p = 0.006) and larger in men compared to women (p = 0.000). The average spur height was also greater in men (p = 0.039). Lateral spurs were the most common type that was observed. This study highlights the differences in bicipital groove morphology and spur formation by age and gender, with 3D-CT being more effective in detecting biceps spurs.

BACKGROUND:Even though arthroscopic rotator cuff repair is recognized as a standard treatment option, the risk of postoperative retear is a major concern.PURPOSE:To evaluate the effect of porcine-derived absorbable patch-type atelocollagen during arthroscopic rotator cuff repair.STUDY DESIGN:Randomized controlled trial; Level of evidence, 1.METHODS:A total of 64 patients with rotator cuff tears diagnosed on magnetic resonance imaging (MRI) were enrolled prospectively from November 2020 to December 2021. Both groups had repairs using the suture bridge technique. For the atelocollagen group, before securing the lateral anchors, we inserted porcine-derived absorbable patch-type atelocollagen between the footprint and the tendon. On postoperative day 2, the patients underwent MRI to confirm containment of the patch-type atelocollagen. At 6 months and 1 year postoperatively, the signal intensity of the repaired tendon was assessed using MRI. Patients were evaluated using the Constant score as the primary outcome, along with the visual analog scale for pain; range of motion; American Shoulder and Elbow Surgeons score; University of California, Los Angeles, score; and Korean Shoulder Score preoperatively and at 2, 3, 6, and 12 months postoperatively.RESULTS:No significant changes in the Constant score as primary outcome, pain or other functional scores, and range of motion were observed between the groups at 1 year postoperatively. The patch-type atelocollagen was confirmed to be contained by the time-zero MRI scan taken 2 days postoperatively. Among the 55 patients included in final analysis, 12 retear cases were recorded (21.8% retear rate). A significantly lower retear rate was found in the atelocollagen group, as 3 cases were observed in this group (10.3%) and 9 cases were observed in the conventional repair group (34.6%) (P = .048).CONCLUSION:The Constant score was not different between the groups. The retear rate after rotator cuff repair was significantly lower in the group that received porcine-derived absorbable patch-type atelocollagen compared with in the conventional group.REGISTRATION:KCT0005184 (Clinical Research Information Service [CRIS]; https://cris.nih.go.kr).

The human clavicle’s unique S-shaped, three-dimensional structure complicates fracture management. This study evaluated the anatomical conformity of pre-contoured anatomical plates using 3D-printed clavicle models. CT scans from 30 patients (15 males and 15 females) were used to create these models. Three brands of distal clavicle plate systems (Acumed, Synthes, and Arthrex) were tested for fit. Measurements included the distance from the distal end of the clavicle to the plate’s lateral end, the gap between the clavicle and the plate, and the overhang distance. Results showed significant differences in clavicle length between sexes, with men having a mean length of 156.1 ± 7.6 mm and women 138.4 ± 4.3 mm, both with normal distribution (p > 0.05). The mean lateral distance was 7.9 ± 1.7 mm, and the mean medial gap was 3.6 ± 3.0 mm, showing no significant differences between products or sexes. The mean overhang distance was 5.8 ± 4.6 mm, with larger values in women for the Acumed (p = 0.037) and Arthrex (p = 0.000) plates. Overall, pre-contoured plates exhibited notable discrepancies, especially in shorter clavicles.

Background: To date, it is not well known which systemic pathologies most frequently afflict patients with rotator cuff tear (RCT) and whether the coexistence of two or more pathologies can affect the lesion size. Therefore, we analyzed our database relative to a large group of patients who recently underwent rotator cuff repair. Methods: A total of 527 patients with full-thickness RCT were enrolled. For each patient, we checked the presence of at least one of diabetes, venous system diseases, cardiovascular diseases, hypercholesterolemia, blood hypertension, thyroid diseases, and a smoking habit. Patients were subdivided according to risk factors into five groups, representing those who had zero, one, two, three, and four or more risk factors, respectively. Statistical analysis was performed. Results: In total, 37% of our patients had no risk factors; 28% had one risk factor (arterial hypertension, smoking habit, and hypercholesterolemia were the most frequent); 23% had two risk factors (the hypertension/hypercholesterolemia association was the most frequent); and 8% suffered from three pathologies (the diabetes/arterial hypertension/hypercholesterolemia association was the most frequent). Comparing the cuff tear severity in patients without and with at least one risk factor, we observed that tear size increased in those with at least one risk factor. Conclusions: A total of 63% of patients with rotator cuff tears were either smokers and/or had at least one pathology capable of altering the peripheral microcirculation. Hypertension and hypercholesterolemia were the most frequent. Tear severity significantly increased with the presence of at least one risk factor.

PURPOSE:Although hook plate fixation is popularly used, concerns exist regarding periprosthetic fractures and the necessity to remove the plate to prevent subacromial erosion and subsequent acromion fracture, due to its non-anatomical design. We hypothesized that a low profile 2.7 mm distal locking hook plate would provide comparable stability to a properly used 3.5 mm distal locking hook plate MATERIALS AND METHODS: A 3.5 mm distal locking plate (type 1) and a low profile 2.7 mm plate (type 2) were assessed by finite element analysis. Peak von Mises stress (PVMS) was calculated on the acromion's undersurface, clavicle shaft, and hook, focusing on how these stresses varied with the number and placement of distal locking screws. RESULTS:Increased distal screws in both types led to lower PVMS on the acromion's undersurface and the hook, with the lowest acromion PVMS observed in type 2 with three distal screws, and on the hook in type 1 with two distal screws. Increasing the number of distal screws similarly reduced PVMS on the clavicle shaft, with the lowest in type 1 with two distal screws. In both plate types, the most posterior distal locking screw played a crucial role in distributing stress across the acromion and the hook. CONCLUSION:The low profile 2.7 mm distal locking hook plate showed comparable biomechanical results to the 3.5 mm distal locking hook plate. Increasing the number of distal locking screws showed less stress concentration on the bone and hook in both models. The most posterior distal locking screw showed an essential role in stress distribution.

Background: Little is known about alterations of the rotator cuff (RC) macroscopic vasculature associated with medical conditions and/or habits that predispose a person to diseases of the peripheral microcirculation. The high frequency of cuff tear and re-tear in patients with diabetes, hypercholesterolemia, uncontrolled arterial hypertension, or metabolic syndrome may be due to tissue hypovascularity.Methods: The macroscopic vasculature of both the articular and bursal sides of the posterosuperior RC was evaluated arthroscopically in 107 patients (mean age, 58.2 years) with no RC tear. Patients were divided into three groups according to medical comorbidities and lifestyle factors (group I, none; group II, smokers and/or drinkers and one comorbidity; and group III, two or more comorbidities). Pulsating vessels originating from both the myotendinous and osteotendinous junctions were assessed as “clearly evident,” “poorly evident,” or “not evident.” Results: Groups I, II, and III comprised 36, 45, and 26 patients, respectively. Within the myotendinous junction, vessels were visualized in 22 group I patients (61%), 25 group II patients (55%), and 6 group III patients (23%) (P=0.007). Pulsating arterial vessels originating from the osteotendinous junction were seen in 42%, 36%, and 0% of patients, respectively (P<0.001). Within the bursal side of the RC, a dense anastomotic network was visualized (either clearly or poorly) in 94% (34), 80% (36), and 35% (9) of patients, respectively (P<0.001).Conclusions: The macroscopic vasculature of the RC is influenced by pre-existing diseases and lifestyle factors, which may impair peripheral microcirculation. Level of evidence: III.

BACKGROUND:A precontoured plate rarely fits properly within the patient's clavicle and must be bent intraoperatively. This study aimed to determine whether anatomical reduction could be achieved using a plate bent before surgery.METHODS:This study included 87 consecutive patients with displaced mid-shaft clavicle fractures who underwent plate fixation and were followed-up for a minimum of 1 year. After exclusions, 39 consecutive patients underwent fixation with a precontoured plate bent intraoperatively (intraoperative bending group), and 28 underwent fixation with the plate bent preoperatively (preoperative bending group). Using free software and a three-dimensional (3D) printer, ipsilateral clavicle 3D-printed models were constructed. Using plain radiographs, the distance between the edge of the lateral inferior cortex and the medial inferior cortex was measured. The angle between the line connecting the inferior cortex edge and the line passing through the flat portion of the superior cortex of the distal clavicle was measured.RESULTS:Mean length differences between the ipsilateral and contralateral clavicle were smaller on both anteroposterior (AP; P=0.032) and axial images (P=0.029) in the preoperative bending group. The mean angular differences on both AP (P=0.045) and axial images (P=0.008) were smaller in the preoperative bending group. No significant differences were observed between the two groups in functional scores at the last follow-up.CONCLUSIONS:Smaller differences in length and angle between the ipsilateral and contralateral clavicle, indicative of reduction, were observed in the preoperative bending group. Using the precontoured technique with low expense, the operation was performed more effectively as reflected by a shorter operation time. Level of evidence: III.

Rotator cuff tear is a common shoulder injury that compromises both function and quality of life. Despite the prevalence of the injury and advancements in repair techniques, a significant percentage of these repairs fail. This review aims to explore the multifactorial reasons behind this failure, including the degenerative nature of the rotator cuff tendon, inherent and extrinsic factors, and the role of hypoxia in tissue degeneration. Additionally, it elucidates potential strategies for improving healing outcomes.

Objectives: This study investigated the epidemiological and etiological trends associated with elbow pain over the past decade in South Korea. Methods: Nationwide health statistics data from 2011 to 2020 pertaining to elbow pain related diseases and soft tissue damages were sourced from the Healthcare Bigdata Hub with disease codes M771 (lateral epicondylitis), M770 (medial epicondylitis), S53 (elbow injury, dislocation, sprain), and G56 (mononeuropathies of the upper limb). The study assessed the annual fluctuations in the total medical cost and the number of patients associated with these codes. Trends over time were characterized by evaluating the crude and age-standardized prevalence rates and the annual percentage change. Changes in the proportion of medical expenses based on age distribution were also investigated. Results: A significant surge in medical costs was observed across all four codes. The M771, M770, and G56 codes experienced a pronounced increase in crude and age-standardized prevalence. Conversely, only S53 registered a significant drop in age-standardized prevalence. Moreover, within the total medical expenditures for the M771 code, the age bracket of 50 to 59 represented the largest proportion. Conclusion: The data suggest that the average age of patients reporting elbow pain is rising. Given this shifting trend in South Korea's health statistics concerning elbow pain, there will be an increasing need for socioeconomic support, which will in turn necessitate improving health policies that address allocating medical expenses and resources for elbow pain.