scholarly journals Performance and Return to Sport Following Ulnar Nerve Transposition/Decompression in Professional Baseball Players

2018 ◽  
Vol 6 (7_suppl4) ◽  
pp. 2325967118S0016
Author(s):  
Brandon J. Erickson ◽  
Peter Nissen Chalmers ◽  
John D’Angelo ◽  
Kevin Ma ◽  
Anthony A. Romeo
Keyword(s):  
Ulnar Nerve ◽  
Performance Metrics ◽  
Return To Sport ◽  
Professional Baseball ◽  
Baseball Players ◽  
Nerve Decompression ◽  
Ulnar Nerve Transposition ◽  
Significant Difference ◽  
And Performance ◽  
Nerve Transposition

Background: Isolated ulnar nerve decompression/transposition is an uncommon surgery amongst professional baseball players. Purpose: To determine the rate of return to sport (RTS) and performance upon RTS in professional baseball players following isolated ulnar nerve decompression/transposition, including those who required an ulnar nerve transposition/decompression following ulnar collateral ligament reconstruction (UCLR), and to determine if outcomes differ between players with isolated ulnar nerve decompression/transposition and matched controls. Hypothesis: There is a high rate of RTS in professional baseball players undergoing isolated ulnar nerve decompression/transposition with no significant difference in RTS rate or performance (specifically related to the primary outcome performance variables of earned run average (ERA), WHIP ((walks +hits)/innings pitched), wins above replacement (WAR), and on base + slugging percentage (OPS)) between cases and controls. Methods: All professional baseball players who underwent isolated ulnar nerve decompression/transposition between 2010-2016 were included. Demographic and performance data (pre and post surgery) for each player was recorded. Performance metrics were then compared between cases and a group of matched controls. Results: Overall 52 players, 83% pitchers (14 who underwent prior UCLR) were included. Most surgeries (92%) were anterior subcutaneous transpositions. Overall, 62% of players were able to successfully RTS and 56% returned to the same or a higher level. There was no significant difference between cases and controls in the majority of performance metrics pre-operative or post-operatively, specifically ERA, WHIP, WAR, and OPS. When players who had a UCLR prior to their ulnar nerve transposition/decompression were compared to controls with a history of a UCLR but who did not go on to have an ulnar nerve transposition/decompression, the only performance difference of all the recorded metrics was cases allowed more walks per 9 innings (4.4 vs. 2.8; p=0.011). Conclusion: Anterior subcutaneous transposition is the most common surgery in professional baseball players to address ulnar nerve compression. Players have a 62% rate of RTS. Upon RTS, players performance compared to matched controls remains the same in the majority of performance metrics including ERA, WHIP, WAR, and OPS. Post-operatively, pitchers with a UCLR prior to ulnar nerve transposition/decompression performed the same as matched controls with prior UCLR.

Performance and Return to Sport After Ulnar Nerve Decompression/Transposition Among Professional Baseball Players

2019 ◽  
Vol 47 (5) ◽  
pp. 1124-1129 ◽  
Author(s):  
Brandon J. Erickson ◽  
Peter N. Chalmers ◽  
John D’Angelo ◽  
Kevin Ma ◽  
Anthony A. Romeo
Keyword(s):  
Ulnar Nerve ◽  
Surgical Procedure ◽  
Performance Metrics ◽  
Major League Baseball ◽  
Return To Sport ◽  
Professional Baseball ◽  
Baseball Players ◽  
Nerve Decompression ◽  
Significant Difference ◽  
Major League

Background: Isolated ulnar nerve decompression/transposition is an uncommon surgical procedure among professional baseball players. Purpose/Hypothesis: To determine performance and rate of return to sport (RTS) among professional baseball players after isolated ulnar nerve decompression/transposition, including those who required decompression/transposition after ulnar collateral ligament reconstruction (UCLR), and to compare outcomes between cases and matched controls. The authors hypothesized a high rate of RTS among professional baseball players undergoing isolated ulnar nerve decompression/transposition with no difference in RTS rate or performance between cases and controls as related to earned run average, WHIP ([walks + hits]/innings pitched), wins above replacement, and on base + slugging percentage. Study Design: Cohort study; Level of evidence, 3. Methods: Utilizing the injury database of Major League Baseball, we identified all professional baseball players who underwent isolated ulnar nerve decompression/transposition between 2010 and 2016. De-identified demographic and performance data (before and after surgery) for each player were recorded from Major League Baseball records. Performance metrics were then compared between cases and matched controls. Results: The study included 52 players; 83% were pitchers; and 14 underwent prior UCLR. Most surgical procedures (92%) were anterior subcutaneous transpositions. Overall, 62% of players were able to successfully RTS, and 56% returned to the same or higher level. There was no significant difference between cases and controls in the majority of pre- and postoperative performance metrics—specifically, earned run average, WHIP, wins above replacement, and on base + slugging percentage. When players who had UCLR before ulnar nerve decompression/transposition were compared with controls with a history of UCLR but no subsequent ulnar nerve decompression/transposition, the only performance difference of all the recorded metrics was that cases allowed more walks per 9 innings (4.4 vs 2.8, P = .011). Conclusion: Anterior subcutaneous transposition is the most common surgical procedure among professional baseball players to address ulnar neuropathy at the elbow. Players have a 62% rate of RTS, which is lower than expected for this nonreconstruction or repair procedure. For players who successfully RTS, performance metrics versus matched controls remained the same except for allowing significantly more walks per 9 innings. Postoperatively, pitchers with UCLR before ulnar nerve decompression/transposition who had a successful RTS performed the same as matched controls with prior UCLR without subsequent ulnar nerve decompression/transposition.

scholarly journals Performance and Return to Sport Following Open Reduction Internal Fixation About the Elbow in Professional Baseball Players

2019 ◽  
Vol 7 (7_suppl5) ◽  
pp. 2325967119S0037
Author(s):  
Brandon J. Erickson ◽  
Peter Nissen Chalmers ◽  
John D’Angelo ◽  
Kevin Ma ◽  
Anthony A. Romeo
Keyword(s):  
Stress Fracture ◽  
Open Reduction ◽  
Performance Metrics ◽  
Return To Sport ◽  
Olecranon Fracture ◽  
Professional Baseball ◽  
Baseball Players ◽  
Significant Difference ◽  
And Performance ◽  
Olecranon Fractures

Objectives: The results of open reduction and internal fixation (ORIF) of stress reactions and fractures of the olecranon in professional baseball players with regards to return to sport (RTS) are unknown. The purpose was to determine the RTS rate and performance in professional baseball players following ORIF of acute, displaced olecranon fractures and olecranon stress fractures, and to compare RTS rate and performance to matched controls. The authors hypothesized that there is a high rate of RTS in professional baseball players following ORIF of acute, displaced olecranon fractures and olecranon stress fractures with no significant difference in rate of RTS or performance, specifically related to the primary outcome performance variables of win-loss percentage (W-L%), WHIP ((walks +hits)/innings pitched), fielding independent pitching (FIP), and wins above replacement (WAR)) between cases and controls between cases and controls. Methods: All professional baseball players who underwent ORIF of the olecranon between 2010-2016 were included. Demographic and performance data (pre and post surgery) for each player was recorded. Performance metrics were then compared between cases and a group of matched controls. Results: Overall, 52 professional baseball players (average age 22.6 +/- 3.6 years) underwent ORIF of an olecranon fracture. The majority of players sustained a primary olecranon stress fracture (73%), that was fixed with one screw (60%), with a RTS rate of 67.5%. No difference in RTS rate existed between matched controls and the players. No significant difference existed between the primary preoperative and postoperative performance (change in performance) metrics for pitchers who underwent ORIF of an acute, displaced olecranon fracture or ORIF of a primary olecranon stress fracture. No significant difference existed between pitchers who underwent ORIF of a primary olecranon stress fracture and matched controls in any of the primary performance metrics. Conclusion: Professional baseball players who undergo ORIF of an olecranon fracture (either acute, displaced or stress fracture) have a RTS rate of 67.5%, which is no different than natural attrition from matched controls. No decline in performance metrics is seen in players who are able to RTS when compared to their preoperative performance, or to the performance of matched controls.

Performance and Return to Sport After Open Reduction and Internal Fixation of the Olecranon in Professional Baseball Players

2019 ◽  
Vol 47 (8) ◽  
pp. 1915-1920 ◽  
Author(s):  
Brandon J. Erickson ◽  
Peter N. Chalmers ◽  
John D’Angelo ◽  
Kevin Ma ◽  
Christopher S. Ahmad ◽  
...  
Keyword(s):  
Stress Fracture ◽  
Open Reduction ◽  
Performance Metrics ◽  
Return To Sport ◽  
Olecranon Fracture ◽  
Professional Baseball ◽  
Baseball Players ◽  
Significant Difference ◽  
And Performance ◽  
Olecranon Fractures

Background: The results of open reduction and internal fixation (ORIF) of stress reactions and fractures of the olecranon among professional baseball players with regard to return to sport (RTS) are unknown. Purpose/Hypothesis: To determine the RTS rate and performance of professional baseball players after ORIF of acute, displaced olecranon fractures and olecranon stress fractures and to compare the RTS rate and performance with that of matched controls. The authors hypothesized that there is a high rate of RTS among professional baseball players after ORIF of acute, displaced olecranon fractures and olecranon stress fractures with no significant difference in rate of RTS or performance between cases and controls. Study Design: Cohort study; Level of evidence, 3. Methods: All professional baseball players who underwent ORIF of the olecranon between 2010 and 2016 were included. Demographic and performance data (before and after surgery) for each player were recorded. Performance metrics were then compared between cases and a group of matched controls. Results: Overall, 52 professional baseball players (mean ± SD age, 22.6 ± 3.6 years) underwent ORIF of an olecranon fracture. The majority of players sustained a primary olecranon stress fracture (73%) that was fixed with 1 screw (60%), with an overall RTS rate of 67.5%. No difference in RTS rate existed between matched controls and the cases. No significant difference existed between the primary pre- and postoperative performance metrics (ie, change in performance) for pitchers who underwent ORIF of an acute, displaced olecranon fracture or ORIF of a primary olecranon stress fracture. No significant difference existed between pitchers who underwent ORIF of a primary olecranon stress fracture and matched controls in any of the primary performance metrics. Three cases and 2 controls underwent ulnar collateral ligament reconstruction later in their careers after olecranon ORIF. Conclusion: Professional baseball players who undergo ORIF of an olecranon fracture (acute, displaced, or stress) have an RTS rate of 67.5% (57.6% to the same or higher level), which is no different from natural attrition among matched controls. No decline in performance metrics was seen among players who were able to RTS when compared with their preoperative performance or the performance of matched controls.

scholarly journals Update On Performance And Return To Sport After Biceps Tenodesis In Professional Baseball Players (226)

2021 ◽  
Vol 9 (10_suppl5) ◽  
pp. 2325967121S0033
Author(s):  
Brandon Erickson ◽  
Peter Chalmers ◽  
John Dangelo ◽  
Kevin Ma ◽  
Dana Rowe ◽  
...  
Keyword(s):  
Performance Metrics ◽  
Return To Sport ◽  
Interference Screw ◽  
Return To Play ◽  
Professional Baseball ◽  
Biceps Tenodesis ◽  
Baseball Players ◽  
Slap Repair ◽  
History Of ◽  
And Performance

Objectives: Determine the return to sport (RTS) rate and performance upon RTS in professional baseball players who underwent biceps tenodesis. Methods: All professional baseball pitchers who underwent biceps tenodesis between 2014 and 2017 were included. Players with concomitant rotator cuff repair were excluded. Demographic and performance data (preoperative and postoperative) were recorded for each player. Performance metrics were then compared between the biceps tenodesis and matched control (no history of biceps tenodeses) groups. Results: 14 players (average age 27±4 years; 12 pitchers, 2 position outfielders) were included. Most (79%) were open subpectoral tenodeses while one was an arthroscopic biceps transfer and one was arthroscopic suprapectoral. Fixation methods included cortical button (42%), interference screw (25%), suture anchor (25%) and drill holes (8%). Most players (79%) underwent concomitant procedures (43% underwent SLAP repair). Among the 14 players, 2 were unable to RTS, 5 RTS but to a lower level, and 7 RTS at the same or a higher level. Thus, overall, while 86% (12/14) were able to RTS, 50% (7/14) were able to return to the same or a better level and 50% were either unable to return or returned to a lower level. Among pitchers specifically, 100% (12/12) were able to return to play, but only 50% (6/12) were able to return to the same or a higher level. For those players who did return to play, it took 245±84 days, their performance was unchanged and did not differ from matched controls. Conclusions: While 86% of professional baseball players returned to sport following biceps tenodesis, only 50% returned at the same or higher level. No decline in performance was noted in players who successfully returned. Open subpectoral tenodesis is the most common tenodesis technique performed on professional baseball players.

Performance and Return to Sport Following Ulnar Nerve Decompression/Transposition in Professional Baseball Players

2019 ◽  
Vol 51 (Supplement) ◽  
pp. 9
Author(s):  
John D’Angelo ◽  
Brandon Erickson ◽  
Peter Chalmers ◽  
Kevin Ma ◽  
Anthony Romeo
Keyword(s):  
Ulnar Nerve ◽  
Return To Sport ◽  
Professional Baseball ◽  
Baseball Players ◽  
Nerve Decompression

scholarly journals Performance and Return to Sport Following Latissimus Dorsi and Teres Major Injuries in Professional Baseball Pitchers

2018 ◽  
Vol 6 (7_suppl4) ◽  
pp. 2325967118S0014
Author(s):  
Brandon J. Erickson ◽  
Peter Nissen Chalmers ◽  
John D’Angelo ◽  
Kevin Ma ◽  
Anthony A. Romeo
Keyword(s):  
Operative Treatment ◽  
Latissimus Dorsi ◽  
Performance Metrics ◽  
Return To Sport ◽  
Professional Baseball ◽  
Performance Variables ◽  
Significant Difference ◽  
Teres Major ◽  
Baseball Pitchers ◽  
And Performance

Background: Latissimus dorsi and teres major (LD/TM) tears are becoming an increasing common cause of injury and disability amongst professional baseball pitchers. Purpose: To determine the rate of return to sport (RTS) and performance upon RTS in professional baseball pitchers following LD/TM tears treated both operatively and non-operatively, and to see if there is a difference in RTS rate and performance between players who sustained a LD/TM tear and matched controls within each treatment group. Hypothesis: There is a high rate of RTS in professional baseball pitchers following LD/TM tears with no significant difference in rate of RTS or performance, specifically related to the primary outcome performance variables of earned run average (ERA), WHIP ((walks +hits)/innings pitched), fielding independent pitching (FIP), and wins above replacement (WAR)) between cases and controls for both operative and non-operative treatment. Methods: All professional baseball pitchers who sustained a LD/TM tear between 2011-2016 were included. Demographic and performance data (pre and post injury) for each player was recorded. Performance metrics were then compared between cases and matched controls within both operatively non-operative treatment. Results: Overall 120 pitchers sustained a LD/TM tear; 42 (35%) were playing at the major league level at the time of injury. The majority of players (107 (89.2%)) were treated non-operatively. The average time to return to the same level of competition for pitchers treated non-operatively was 170.7 +/- 169.7 days while for those treated operatively was 536.6 +/- 300.4 days. Of the players treated with surgery, the mean time from injury to surgery was 97.5+/-115.5 days (range 12-453 days). The RTS rate among players treated non-operatively and operatively was identical at 75%. Players treated non-operatively had no change in ERA, FIP, or WAR following injury but had a higher WHIP after injury (p=0.039). Players treated operatively had no change in any measured performance metrics following surgery. No difference existed between cases and controls in the primary performance variables Conclusion: LD/TM tears occur more frequently than previously reported. The majority of LD/TM tears in professional baseball pitchers are treated non-operatively. RTS rate for professional baseball pitchers following LD/TM tears treated operatively or non-operatively is 75%. No significant difference in performance was seen in these pitchers following tear/surgery compared to matched controls.

scholarly journals Performance and Return to Sport After Anterior Cruciate Ligament Reconstruction in Professional Baseball Players

2019 ◽  
Vol 7 (10) ◽  
pp. 232596711987843
Author(s):  
Brandon J. Erickson ◽  
Peter N. Chalmers ◽  
John D’Angelo ◽  
Kevin Ma ◽  
Diane L. Dahm ◽  
...  
Keyword(s):  
Ligament Reconstruction ◽  
Performance Metrics ◽  
Cruciate Ligament ◽  
Return To Sport ◽  
Professional Baseball ◽  
Baseball Players ◽  
Cruciate Ligament Reconstruction ◽  
Significant Difference ◽  
Drilling Technique ◽  
Anterior Cruciate

Background: Anterior cruciate ligament reconstruction (ACLR) is the gold standard treatment for ACL tears to allow baseball players to return to sport (RTS). The optimal graft type and femoral tunnel drilling technique are currently unknown. Hypothesis: There is a high rate of RTS in professional baseball players after ACLR, with no significant difference in RTS rates or performance between cases and controls or between graft types or femoral drilling techniques. Study Design: Cohort study; Level of evidence, 3. Methods: All professional baseball players who underwent ACLR between 2010 and 2015 were included. Demographic and performance data (pre- and postoperative) for each player were recorded. Performance metrics were then compared between cases and matched controls. Results: A total of 124 players (mean age, 23.7 ± 4.1 years; 83% minor league players) underwent ACLR. Of these, 80% returned to sport (73% to the same or higher level) at a mean 310 ± 109 days overall and 333 ± 126 days at the same or higher level. The most common graft type was an ipsilateral bone–patellar tendon–bone (BTB) autograft (n = 87; 70%). A total of 91 players underwent concomitant meniscal debridement or repair. No significant difference in any of the primary performance metrics existed from before to after ACLR. Compared with matched controls, no significant difference existed in RTS rates or any performance metrics after ACLR. No significant difference existed in RTS rates or primary performance outcome measures between graft types or femoral drilling techniques. Conclusion: The RTS rate for professional baseball players after ACLR was 80%. No significant difference in performance metrics existed between BTB and hamstring autografts or between femoral drilling techniques. Furthermore, no significant difference in performance or RTS rates existed between cases and matched controls. Femoral drilling technique and graft type did not affect performance and RTS rates in professional baseball players after ACLR.

Ulnar Neuritis and Its Affect on Outcomes of Elbow Ulnar Collateral Ligament Reconstruction

2021 ◽  
pp. 036354652110538
Author(s):  
Anthony F. De Giacomo ◽  
Robert A. Keller ◽  
Michael Banffy ◽  
Neal S. ElAttrache
Keyword(s):  
Ulnar Nerve ◽  
Return To Sport ◽  
Ulnar Collateral Ligament ◽  
Collateral Ligament ◽  
Baseball Players ◽  
Ulnar Nerve Transposition ◽  
Additional Surgery ◽  
Baseball Pitchers ◽  
Ulnar Neuritis ◽  
Nerve Transposition

Background: No study has specifically evaluated how ulnar neuritis and ulnar nerve transposition affect outcomes in baseball players undergoing ulnar collateral ligament (UCL) reconstruction (UCLR). Purpose: To evaluate the effects of ulnar neuritis and ulnar nerve transposition in baseball pitchers undergoing UCLR in regard to return to sport, time to return to sport, and need for revision or additional surgery. Study Design: Cohort study; Level of evidence, 3. Methods: At a single institution, all consecutive baseball pitchers undergoing UCLR between 2002 and 2015 were identified. Ulnar neuritis was diagnosed preoperatively by the following criteria: ulnar nerve symptoms, Tinel sign at the elbow, symptomatic subluxation, and numbness/paresthesia in an ulnar nerve distribution of the hand. The primary outcome of the study was return to sport. The secondary outcomes of the study were time to return to sport, length of playing career, and revision or additional surgery. Results: A total of 578 UCLRs were performed in baseball players; of these, 500 UCLRs were performed in pitchers. Ulnar neuritis was diagnosed in 97 (19.4%) baseball pitchers presenting with UCL injury. There were no significant differences in patient characteristics or surgical techniques performed for reconstruction between baseball pitchers with and without ulnar neuritis. In review of injury characteristics, ulnar neuritis was significantly more likely to be diagnosed in pitchers with an acute onset of UCL injury ( P = .03). Transposition of the ulnar nerve was more commonly performed in players with ulnar neuritis (47%) versus those without ulnar neuritis (10%; P = .0001). The players who had ulnar neuritis and underwent UCLR had a significantly lower odds of returning to sport (odds ratio, 0.45; P = .04); however, no significant difference was found for time to return to sport and length of playing career for those with and without ulnar neuritis ( P = .38 and .51, respectively). Conclusion: The study suggests that ulnar neuritis, when present preoperatively in baseball pitchers undergoing UCLR, may adversely affect their ability to return to sport, whereas ulnar nerve transposition at the time of UCLR does not alter the ability to return to sport.

Performance and Return to Sport After Latissimus Dorsi and Teres Major Tears Among Professional Baseball Pitchers

2019 ◽  
Vol 47 (5) ◽  
pp. 1090-1095 ◽  
Author(s):  
Brandon J. Erickson ◽  
Peter N. Chalmers ◽  
John D’Angelo ◽  
Kevin Ma ◽  
Anthony A. Romeo
Keyword(s):  
Latissimus Dorsi ◽  
Performance Metrics ◽  
Return To Sport ◽  
Nonoperative Treatment ◽  
Professional Baseball ◽  
Significant Difference ◽  
Major League ◽  
Teres Major ◽  
Baseball Pitchers ◽  
And Performance

Background: Latissimus dorsi and teres major (LD/TM) tears are becoming an increasingly common cause of injury and disability among professional baseball pitchers. Purpose/Hypothesis: To determine performance and return to sport (RTS) among professional baseball pitchers after LD/TM tears treated operatively and nonoperatively and to compare the RTS rate and performance between pitchers who sustained an LD/TM tear and matched controls. The authors hypothesized a high RTS rate among professional baseball pitchers after LD/TM tears, with no significant difference in RTS rate or performance between cases and controls for operative and nonoperative treatment—specifically, in the primary performance outcome variables of WHIP ([walks + hits] / innings pitched), fielding independent pitching, and wins above replacement. Study Design: Cohort study; Level of evidence, 3. Methods: All professional baseball pitchers who sustained an LD/TM tear between 2011 and 2016 were identified with the Health and Injury Tracking System database of Major League Baseball. Demographic and performance data (before and after injury) were recorded for each player. Performance metrics were then compared between cases and matched controls by operative and nonoperative treatment. Results: Overall, 120 pitchers had a documented LD/TM tear; 42 (35%) were major league players. Most players (n = 107, 89.2%) were treated nonoperatively. Time to return to the same level of competition was 170 ± 169 days (mean ± SD) for pitchers treated nonoperatively and 406 ± 146 days for those treated operatively. The RTS rate among players treated nonoperatively and operatively was identical at 75%. Players treated nonoperatively had no change in fielding independent pitching or wins above replacement after injury but had a higher (ie, worse) WHIP after injury ( P = .039); they also performed significantly worse in several secondary performance metrics, including number of games played per year ( P < .001). Players treated operatively had no change in any measured performance metrics after surgery. No difference existed between cases and controls in the primary performance variables. Conclusion: The majority of LD/TM tears are treated nonoperatively. The RTS rate is 75% for professional baseball pitchers after LD/TM tears treated operatively or nonoperatively. Players treated nonoperatively saw a decline in several performance metrics, while players treated operatively had no significant difference in performance after surgery.

Modified Jobe Versus Docking Technique for Elbow Ulnar Collateral Ligament Reconstruction: A Systematic Review and Meta-analysis of Clinical Outcomes

2020 ◽  
Vol 49 (1) ◽  
pp. 236-248
Author(s):  
Austin M. Looney ◽  
David X. Wang ◽  
Christine M. Conroy ◽  
Jake E. Israel ◽  
Blake M. Bodendorfer ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ulnar Nerve ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Ulnar Collateral Ligament ◽  
Likelihood Method ◽  
Collateral Ligament ◽  
Ulnar Nerve Transposition ◽  
Significant Difference ◽  
Nerve Transposition

Background: The modified Jobe and docking techniques are the most common techniques used for elbow ulnar collateral ligament (UCL) reconstruction. Previous systematic reviews have suggested that the docking technique results in superior outcomes as compared with the Jobe (figure-of-8) technique. However, these included results from earlier studies in which the flexor-pronator mass (FPM) was detached and an obligatory submuscular ulnar nerve transposition was performed. Purpose/Hypothesis: The purpose was to compare the outcomes and return-to-play (RTP) time between the docking and figure-of-8 techniques for UCL reconstruction. We hypothesized that there would be no significant difference in the proportion of excellent outcomes between techniques when the FPM was preserved and no obligatory submuscular ulnar nerve transposition was performed. We also hypothesized that there would be no significant difference in RTP time between techniques. Study Design: Systematic review and meta-analysis. Methods: This study was performed in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. In the primary analysis, techniques were compared in random effects models by using the restricted maximum likelihood method, with weighted effect sizes calculated as the Freeman-Tukey double-arcsine transformed proportion of excellent outcomes for variance stabilization and with summary effects estimated from the inverse double-arcsine transformation per the harmonic mean of the sample sizes. Mean RTP times for techniques were compared in a separate model. Results: There were 21 eligible articles identified, with results for 1842 UCL reconstructions (n = 320, docking; n = 1466, figure-of-8). Without controlling for the effects of flexor-pronator detachment and submuscular ulnar nerve transposition, a significantly larger proportion of excellent outcomes was observed with docking reconstruction (86.58%; 95% CI, 80.42%-91.85%) than with figure-of-8 reconstruction (76.76%; 95% CI, 69.65%-83.25%; P = .031); however, there was no significant difference between techniques when controlling for FPM preservation or detachment with submuscular nerve transposition ( P = .139). There was no significant difference between techniques in time to return to sports ( P = .729), although no reconstructions with FPM detachment and submuscular ulnar nerve transposition were available for RTP time analysis. Conclusion: There was no significant difference in the proportion of excellent Conway Scale outcomes or RTP time between the docking and modified Jobe techniques for UCL reconstruction when the FPM was preserved and routine submuscular ulnar nerve transposition was not performed.

Sign in / Sign up

Export Citation Format

Share Document