Wilson Alexander T, Pidgeon Tyler S, Morrell Nathan T, DaSilva Manuel F
Department of Orthopaedics, The Warren Alpert Medical School of Brown University and Rhode Island Hospital, Providence, RI.
Department of Orthopaedics, The Warren Alpert Medical School of Brown University and Rhode Island Hospital, Providence, RI.
J Hand Surg Am. 2015 Nov;40(11):2249-54. doi: 10.1016/j.jhsa.2015.07.024. Epub 2015 Aug 29.
To determine the frequency of revision elbow ulnar collateral ligament (UCL) reconstruction in professional baseball pitchers.
Data were collected on 271 professional baseball pitchers who underwent primary UCL reconstruction. Each player was evaluated retrospectively for occurrence of revision UCL reconstructive surgery to treat failed primary reconstruction. Data on players who underwent revision UCL reconstruction were compiled to determine total surgical revision incidence and revision rate by year. The incidence of early revision was analyzed for trends. Average career length after primary UCL reconstruction was calculated and compared with that of players who underwent revision surgery. Logistic regression analysis was performed to assess risk factors for revision including handedness, pitching role, and age at the time of primary reconstruction.
Between 1974 and 2014, the annual incidence of primary UCL reconstructions among professional pitchers increased, while the proportion of cases being revised per year decreased. Of the 271 pitchers included in the study, 40 (15%) required at least 1 revision procedure during their playing career. Three cases required a second UCL revision reconstruction. The average time from primary surgery to revision was 5.2 ± 3.2 years (range, 1-13 years). The average length of career following primary reconstruction for all players was 4.9 ± 4.3 years (range, 0-22 years). The average length of career following revision UCL reconstruction was 2.5 ± 2.4 years (range, 0-8 years). No risk factors for needing revision UCL reconstruction were identified.
The incidence of primary UCL reconstructions among professional pitchers is increasing; however, the rate of primary reconstructions requiring revision is decreasing. Explanations for the decreased revision rate may include improved surgical technique and improved rehabilitation protocols.
TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
确定职业棒球投手中尺侧副韧带（UCL）重建翻修手术的频率。
收集271例行初次UCL重建的职业棒球投手的数据。对每位球员进行回顾性评估，以确定翻修UCL重建手术治疗初次重建失败的发生率。汇总接受UCL重建翻修手术球员的数据，以确定每年的手术翻修总发生率和翻修率。分析早期翻修发生率的趋势。计算初次UCL重建后的平均职业生涯长度，并与接受翻修手术的球员进行比较。进行逻辑回归分析，以评估翻修的危险因素，包括利手、投球角色和初次重建时的年龄。
1974年至2014年期间，职业投手中初次UCL重建的年发生率增加，而每年翻修病例的比例下降。在纳入研究的271名投手中，40名（15%）在其职业生涯中至少需要1次翻修手术。3例需要第二次UCL翻修重建。初次手术至翻修的平均时间为5.2±3.2年（范围1 - 13年）。所有球员初次重建后的平均职业生涯长度为4.9±4.3年（范围0 - 22年）。UCL重建翻修后的平均职业生涯长度为2.5±2.4年（范围0 - 8年）。未发现需要UCL重建翻修的危险因素。
职业投手中初次UCL重建的发生率在增加；然而，需要翻修的初次重建率在下降。翻修率下降的原因可能包括手术技术的改进和康复方案的改善。
研究类型/证据水平：治疗性IV级。
