scholarly journals Performance and Return to Sport After Thumb Ulnar Collateral Ligament Repair in Major League Baseball Players

2018 ◽  
Vol 6 (1) ◽  
pp. 232596711774726 ◽  
Author(s):  
Robert A. Jack ◽  
Kyle R. Sochacki ◽  
Bryce Gagliano ◽  
David M. Lintner ◽  
Joshua D. Harris ◽  
...  
Keyword(s):  
Index Date ◽  
Major League Baseball ◽  
Return To Sport ◽  
Ulnar Collateral Ligament ◽  
Dominant Hand ◽  
Performance Score ◽  
Collateral Ligament ◽  
Postoperative Performance ◽  
Career Length ◽  
Major League

Background: Acute ruptures of the ulnar collateral ligament (UCL) of the thumb are common injuries in sports. Surgical repair has yielded excellent results and high return-to-sport (RTS) rates in elite athletes. Purpose: To determine (1) the RTS rate in Major League Baseball (MLB) players following thumb UCL repair, (2) postoperative career length and games played per season, (3) pre- and postoperative performance, (4) postoperative performance compared with matched control players, and (5) whether dominant and nondominant hand injuries respond differently. Study Design: Cohort study; Level of evidence, 3. Methods: MLB players who underwent thumb UCL surgery from August 3, 1987, to September 6, 2016, were identified. Demographic and performance data were collected for each player, and matched controls were identified. RTS in the MLB was defined as playing in at least 1 MLB game after surgery. Comparisons were made by use of paired-samples Student t tests. Results: Twenty-one players were identified, with a mean ± SD age of 31.7 ± 3.9 years and mean experience in the MLB of 8.6 ± 3.3 years at time of surgery. Twenty-one players (100%) achieved RTS in the MLB at a mean 120.0 ± 75.9 days. No significant decrease was found in games per season or career length for any position following surgery. Infielders had a significantly lower rate of postoperative wins above replacement (WAR) compared with preoperatively ( P = .006), but no significant differences in postoperative performance score were found compared with controls after the index date. No significant difference was found for performance between players undergoing surgery on their dominant hand and those who had surgery on their nondominant (glove) hand compared with controls. Conclusion: In this study, 100% of MLB players achieved RTS after thumb UCL repair, with in-season players returning at a mean of 8 weeks. Players who underwent thumb UCL repair played in a similar number of games per season and had similar career lengths in the MLB as controls. Infielders had a significantly lower postoperative WAR compared with preoperatively, but no significant postoperative performance score differences were noted when infielders were compared with post–index date matched controls. No significant performance differences were noted with regard to surgery on dominant and nondominant hands.

Performance and Return to Sport After Tommy John Surgery Among Major League Baseball Position Players

2018 ◽  
Vol 46 (7) ◽  
pp. 1720-1726 ◽  
Author(s):  
Robert A. Jack ◽  
Matthew B. Burn ◽  
Kyle R. Sochacki ◽  
Patrick C. McCulloch ◽  
David M. Lintner ◽  
...  
Keyword(s):  
Major League Baseball ◽  
Return To Sport ◽  
High Rate ◽  
Position Change ◽  
Level Of Evidence ◽  
Valgus Stress ◽  
Postoperative Performance ◽  
Career Length ◽  
Major League ◽  
Tommy John

Background: The anterior bundle of the medial ulnar collateral ligament (UCL) is the primary restraint to valgus stress at the elbow and is often injured among overhead throwing athletes. Despite prevention strategies, injuries to the elbow UCL are on the rise. Purpose: To determine (1) the return-to-sport (RTS) rate of Major League Baseball (MLB) position players after elbow medial UCL reconstruction, (2) postoperative career length and games per season, (3) pre- and postoperative performance, (4) postoperative performance versus matched control players, and (5) whether position players changed positions after UCL reconstruction. Study Design: Cohort study; Level of evidence, 3. Methods: MLB players who underwent elbow UCL reconstruction were identified (cases). Demographic and performance data were collected for each player. Matched controls were identified. RTS in MLB was defined as playing in at least 1 MLB game after UCL reconstruction. Comparisons between case and control groups and pre- and postoperative time points were made via paired samples Student t tests. Results: Thirty-three players (34 surgical procedures) were identified with a mean ± SD age of 30.2 ± 4.2 years and a mean experience in the MLB of 6.3 ± 3.9 years at the time of surgery. Twenty-eight players (84.8%) were able to RTS in MLB at a mean 336.9 ± 121.8 days. However, players ≥30 years old demonstrated a significantly lower RTS rate (53.3%) than players <30 years old (89.4%; P < .05). Catchers had a significantly shorter postoperative career length (2.8 ± 1.8 years) versus matched controls (6.1 ± 1.9 years; P < .05). Outfielders had a significantly lower wins above replacement postoperatively (0.8 ± 0.7) versus preoperatively (1.5 ± 1.1; P < .05). There were no performance differences between cases and matched controls. Twelve players (48%) returned to a different position postoperatively. Conclusion: The RTS rate for MLB position players after elbow UCL reconstruction is similar to that of pitchers. Catchers had a significantly shorter career length than that of matched controls. Outfielders performed worse postoperatively versus preoperatively. There is a high rate of position change after Tommy John surgery for infielders and outfielders.

Outcomes With a Focus on Return to Play for Revision Ulnar Collateral Ligament Surgery Among Elite-Level Baseball Players: A Systematic Review

2018 ◽  
Vol 47 (11) ◽  
pp. 2759-2763 ◽  
Author(s):  
Georgina Glogovac ◽  
Brian M. Grawe
Keyword(s):  
Systematic Review ◽  
Major League Baseball ◽  
Return To Sport ◽  
Ulnar Collateral Ligament ◽  
Rate Of Return ◽  
Secondary Outcome ◽  
Collateral Ligament ◽  
Baseball Players ◽  
Major League ◽  
Elite Level

Background: Ulnar collateral ligament (UCL) reconstruction is commonly performed among overhead throwing athletes. Previous studies demonstrated relatively high rates of return to sport after primary reconstruction. Outcomes after revision UCL reconstruction have not been widely studied. Purpose: To report the rate of return to sport after revision UCL reconstruction among elite-level baseball players. Study Design: Systematic review. Methods: A systematic review of the literature following the PRISMA (Preferred Reporting Items for Systematic Meta-Analyses) guidelines was performed for high-level baseball players undergoing revision UCL reconstruction. Study bias was assessed with the Methodological Index for Non-Randomized Studies scoring system. The primary outcome measure was whether the study participants were able to return to sport after revision UCL reconstruction. Secondary outcome measures included career length after revision and pitching performance statistics. Data were summarized with ranges, tables, and weighted averages. A subjective analysis was performed. Results: A total of 5 studies met inclusion criteria. The rate of return to sport at preinjury level was 62.8%. Among Major League Baseball pitchers, the rate of return to sport at the preinjury level was 68.8%. The rate of return to sport at the same level or lower (Major League Baseball, minor league, collegiate) was 78.1%. Time to return to sport ranged from 1.3 to 1.7 years. Mean earned run average after revision ranged from 4.87 to 5.04. Mean number of innings pitched per season after revision ranged from 36.95 to 50.5. Conclusion: This systematic review demonstrated a limited rate of return to preinjury level of sport among elite-level baseball players who underwent revision UCL reconstruction. Pitching durability and career longevity were inferior to results that were reported for players who underwent primary UCL reconstruction alone. This study suggests that outcomes after revision UCL reconstruction are not reliable and elite-level players should be counseled accordingly.

scholarly journals Effect of Ulnar Collateral Ligament Reconstruction on Pitch Accuracy, Velocity, and Movement in Major League Baseball Pitchers

2020 ◽  
Vol 8 (12) ◽  
pp. 232596712096853
Author(s):  
Braden McKnight ◽  
Nathanael D. Heckmann ◽  
Xiao T. Chen ◽  
Kevork Hindoyan ◽  
J. Ryan Hill ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Major League Baseball ◽  
Ulnar Collateral Ligament ◽  
Poor Performance ◽  
Return To Play ◽  
Collateral Ligament ◽  
Level Of Evidence ◽  
Major League ◽  
The Mean ◽  
Performance Statistics

Background: Ulnar collateral ligament (UCL) reconstruction is frequently performed on Major League Baseball (MLB) pitchers. Previous studies have investigated the effects of UCL reconstruction on fastball and curveball velocity, but no study to date has evaluated its effect on fastball accuracy or curveball movement among MLB pitchers. Purpose/Hypothesis: The primary purpose of this study was to determine the effects of UCL reconstruction on fastball accuracy, fastball velocity, and curveball movement in MLB pitchers. Our hypothesis was that MLB pitchers who underwent UCL reconstruction would return to their presurgery fastball velocity, fastball accuracy, and curveball movement. The secondary purpose of this study was to determine which factors, if any, were predictive of poor performance after UCL reconstruction. Study Design: Case-control study; Level of evidence, 3. Methods: MLB pitchers who underwent UCL reconstruction surgery between 2011 and 2012 were identified. Performance data including fastball velocity, fastball accuracy, and curveball movement were evaluated 1 year preoperatively and up to 3 years of play postoperatively. A repeated-measures analysis of variance with a Tukey-Kramer post hoc test was used to determine statistically significant changes in performance over time. Characteristic factors and presurgery performance statistics were compared between poor performers (>20% decrease in fastball accuracy) and non—poor performers. Results: We identified 56 pitchers with a total of 230,995 individual pitches for this study. After exclusion for lack of return to play (n = 14) and revision surgery (n = 3), 39 pitchers were included in the final analysis. The mean presurgery fastball pitch-to-target distance was 32.9 cm. There was a statistically significant decrease in fastball accuracy after reconstruction, which was present up to 3 years postoperatively ( P = .007). The mean presurgery fastball velocity of 91.82 mph did not significantly change after surgery ( P = .194). The mean presurgery curveball movement of 34.49 cm vertically and 5.89 cm horizontally also did not change significantly ( P = .937 and .161, respectively). Conclusion: Fastball accuracy among MLB pitchers significantly decreased after UCL reconstruction for up to 3 years postoperatively. There were no statistically significant differences in characteristic factors or presurgery performance statistics between poor and non--poor performers.

scholarly journals Should We Limit Innings Pitched Following Ulnar Collateral Ligament Reconstruction in Major League Baseball Pitchers?

2016 ◽  
Vol 4 (7_suppl4) ◽  
pp. 2325967116S0010
Author(s):  
Brandon J. Erickson ◽  
Gregory Cvetanovich ◽  
Bernard R. Bach ◽  
Charles A. Bush-Joseph ◽  
Nikhil N. Verma ◽  
...  
Keyword(s):  
Ligament Reconstruction ◽  
Major League Baseball ◽  
Ulnar Collateral Ligament ◽  
Collateral Ligament ◽  
Major League ◽  
Baseball Pitchers ◽  
Ulnar Collateral Ligament Reconstruction

scholarly journals Performance and Return to Sport After Hip Arthroscopic Surgery in Major League Baseball Players

2019 ◽  
Vol 7 (2) ◽  
pp. 232596711982583 ◽  
Author(s):  
Robert A. Jack ◽  
Kyle R. Sochacki ◽  
Takashi Hirase ◽  
Justin Vickery ◽  
Patrick C. McCulloch ◽  
...  
Keyword(s):  
Major League Baseball ◽  
Statistical Significance ◽  
Arthroscopic Surgery ◽  
Return To Sport ◽  
Control Group ◽  
P Value ◽  
Postoperative Performance ◽  
Significant Difference ◽  
Major League ◽  
And Performance

Background: Femoroacetabular impingement (FAI) is a common cause of hip pain that may lead to decreased performance in Major League Baseball (MLB) players. Purpose: To determine the (1) return-to-sport (RTS) rate in MLB players after hip arthroscopic surgery for FAI; (2) postoperative career length, innings pitched (IP) (pitchers), and plate appearances (PA) (position players); (3) preoperative and postoperative performance; and (4) postoperative performance compared with control players matched by position, age, years of experience, and performance. Study Design: Cohort study; Level of evidence, 3. Methods: MLB athletes who underwent hip arthroscopic surgery for FAI and matched controls were identified. Demographic and performance data were collected. RTS was defined as playing in at least 1 MLB game after surgery. Continuous variables of each group were compared using a 2-tailed paired-samples Student t test for normally distributed data. The chi-square test was used to analyze categorical data. The Bonferroni correction was used to control for multiple comparisons, with statistical significance defined by a P value of ≤.007. Results: A total of 50 players (57 surgeries) were analyzed (mean age, 30.4 ± 3.9 years; mean MLB experience at the time of surgery, 7.0 ± 4.6 years). Pitchers (31 surgeries; 54.4%) represented the largest proportion of players analyzed. Of these players, 42 (47 surgeries; 82.5%) were able to RTS at a mean of 8.3 ± 4.1 months. The overall 1-year MLB career survival rate of players undergoing FAI surgery was 78.9%. Players in the control group were in MLB a similar number of years (4.0 ± 2.9 years) to players who underwent surgery (3.3 ± 2.4 years) ( P > .007). There was no significant decrease in IP or PA per season after surgery ( P > .007). There was no significant difference in performance for pitchers and nonpitchers compared with matched controls after surgery ( P > .007). Conclusion: The RTS rate for MLB athletes after hip arthroscopic surgery for FAI was high. There were similar IP, PA, and career lengths postoperatively compared with preoperatively and with matched controls. There was no significant difference in performance for pitchers and nonpitchers compared with matched controls after surgery.

scholarly journals Performance and Return to Sport After Thumb Ulnar Collateral Ligament Surgery in National Football League Players

Hand ◽  
2018 ◽  
Vol 14 (4) ◽  
pp. 487-493 ◽  
Author(s):  
Kyle R. Sochacki ◽  
Robert A. Jack ◽  
Richard Nauert ◽  
Shari R. Liberman ◽  
Patrick C. McCulloch ◽  
...  
Keyword(s):  
National Football League ◽  
Return To Sport ◽  
Ulnar Collateral Ligament ◽  
High Rate ◽  
Collateral Ligament ◽  
Postoperative Performance ◽  
Paired Samples ◽  
Significant Difference ◽  
Postoperative Time ◽  
And Performance

Background: Acute ruptures of the ulnar collateral ligament (UCL) of the thumb are common injuries in sports. Surgical repair of complete tears has yielded excellent results in elite athletes. Methods: National Football League (NFL) players who underwent thumb UCL surgery and matched controls were identified. Demographic and performance data were collected. Performance scores were calculated using a standardized scoring system. Return to sport (RTS) in the NFL was defined as playing in at least 1 NFL game after thumb UCL surgery. Comparisons between case and control groups and preoperative and postoperative time points were made using paired-samples Student t tests. Results: Twenty-three players were identified (mean age: 28.8 ± 3.4 years and mean experience in the NFL: 5.9 ± 3.4 years). Twenty-two players (95.7%) were able to return to sport in the NFL at an average of 132.2 ± 126.1 days. The overall 1-year NFL career survival rate of players undergoing thumb UCL surgery was 87.0%. There was not a statistically significant decrease in games per season and career length for any position following surgery. No positions had a significant difference in postoperative performance when compared with preoperative performance, and there was no significant performance difference postoperatively when compared with matched controls. Conclusions: There is a high rate of RTS in the NFL following thumb UCL surgery. Players who underwent thumb UCL surgery played in a similar number of games per season and had similar career lengths in the NFL as controls. No position group had any significant postoperative performance score differences when compared with postindex matched controls.

scholarly journals Epidemiology and Impact of Prior Musculoskeletal Injury and Orthopaedic Surgery on Draft Rank, Availability, and Short-term Performance in Major League Baseball: A Summary Analysis and Matched Cohort of 1890 Predraft Players

2019 ◽  
Vol 7 (5) ◽  
pp. 232596711984426
Author(s):  
Prem N. Ramkumar ◽  
Sergio M. Navarro ◽  
Bryan C. Luu ◽  
Heather S. Haeberle ◽  
Jaret M. Karnuta ◽  
...  
Keyword(s):  
Surgical Procedures ◽  
Major League Baseball ◽  
Ulnar Collateral Ligament ◽  
Musculoskeletal Injury ◽  
Musculoskeletal Injuries ◽  
Ligament Injury ◽  
Collateral Ligament ◽  
Short Term ◽  
Level Of Evidence ◽  
Major League

Background: Despite the many reports of injury rates in Major League Baseball (MLB), little is known about the epidemiology or impact of prior musculoskeletal injuries and surgical procedures among players entering the MLB draft. Purpose: To determine the (1) epidemiology of all musculoskeletal injuries and surgical procedures among players entering the MLB draft, (2) impact of injury or surgery on draft rank, (3) impact of injury or surgery on availability within the first 2 years of play in the MLB, and (4) impact of injury or surgery on performance. Study Design: Cohort study; Level of evidence, 3. Methods: We retrospectively reviewed 1890 medical records that were completed by MLB team physicians as preparticipation physical assessment prior to the draft from 2014 to 2018. Players were divided into 3 groups: noninjured, nonoperative, and operative. Draft status, overall draft rank, missed games, batting average, and earned run average for the first 2 seasons of MLB play were obtained for all available players. Players across all 3 groups were compared with linear, logistic, and beta regression models, controlling for age, position, injury status, and draft rank. Unadjusted differences among groups were assessed with 1-way analysis of variance. Results: Overall, 750 position players and 1140 pitchers were included, of whom 22.8% had no reported injury history; 48.8% reported injury treated nonoperatively; and 28.5% were treated operatively. The most common predraft injuries were elbow tendinitis (n = 312), ulnar collateral ligament injury (n = 212), and shoulder labral tear (n = 76). The most common predraft treatments were physical therapy (n = 922), ulnar collateral ligament reconstruction (n = 115), and fracture fixation (n = 69). Of the 1890 players, 719 were drafted and played for at least 2 years. No difference was found among noninjured, nonoperative, and operative groups in terms of draft rank, games missed, or performance. Players with a nonoperative injury had a decreased odds ratio of being drafted (0.738; P = .017). Conclusion: More than half of the players entering the MLB reported a history of musculoskeletal injury requiring treatment, and the most commonly affected joints were the shoulder and elbow. Musculoskeletal history did not affect draft rank, short-term availability, or performance for MLB prospects.

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