Toronto Blue Jays Baseball Club, Toronto, ON, Canada.
Mountain River Physical Therapy, Chatham, VA, USA.
J Shoulder Elbow Surg. 2018 Mar;27(3):561-571. doi: 10.1016/j.jse.2017.12.003.
Ulnar collateral ligament injury (UCLI) has significantly increased in overhead sports during the past 2 decades. Differences in return to sport (RTS) and RTS at previous level (RTSP) after UCLI have not been differentiated.
A computer-assisted literature search of PubMed, CINAHL, Embase, and SportDiscus databases using keywords related to RTS for UCLI was implemented. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used for study methodology. Quality assessment was conducted using a modified Downs and Black scale.
A total of 22 retrospective, level 3b or 4, studies (n = 2289) qualified for analysis. Overall RTS proportion was 90% (95% confidence interval [CI], 86%-94%) and overall RTSP proportion was 79% (95% CI, 75%-84%), both with significant heterogeneity (P < .001, I = 74%-84%). RTS and RTSP proportions were 89% (95% CI, 83%-94%) and 78% (95% CI, 72%-83%) for Major League Baseball players, 91% (95% CI, 77%-99%) and 67% (95% CI, 52%-81%) for Minor League Baseball players, 95% (95% CI, 75%-100%) and 92% (95% CI, 82%-98%) for collegiate players, and 93% (95% CI, 81%-100%) and 83% (95% CI, 77%-89%) for high school players, respectively. Increased earned run average, walks, and hits per inning pitched, decreased innings pitched, and decreased fastball velocity were found after UCLI.
Low-level, high-bias evidence demonstrates overall RTS proportion is higher than RTSP, regardless of treatment type for UCLI. Although RTS proportions remained consistent across various levels of play, RTSP proportions were lower in professional players, particularly Minor League Baseball compared with collegiate and high school players. Pitching performance significantly decreased postoperatively in most studies.
在过去的 20 年中，上肢外展型牵张性损伤（UCLI）在过头运动中显著增加。UCLI 后重返运动（RTS）和以前水平的 RTS（RTSP）的差异尚未得到区分。
使用与 UCLI 的 RTS 相关的关键字，对 PubMed、CINAHL、Embase 和 SportDiscus 数据库进行了计算机辅助文献检索。研究方法采用了系统评价和荟萃分析的首选报告项目指南。使用改良的 Downs 和 Black 量表进行质量评估。
共有 22 项回顾性、3b 级或 4 级研究（n=2289）符合分析标准。总体 RTS 比例为 90%（95%置信区间[CI]，86%-94%），总体 RTSP 比例为 79%（95% CI，75%-84%），均具有显著的异质性（P<0.001，I=74%-84%）。美国职业棒球大联盟球员的 RTS 和 RTSP 比例分别为 89%（95% CI，83%-94%）和 78%（95% CI，72%-83%），小联盟球员分别为 91%（95% CI，77%-99%）和 67%（95% CI，52%-81%），大学生球员分别为 95%（95% CI，75%-100%）和 92%（95% CI，82%-98%），高中生球员分别为 93%（95% CI，81%-100%）和 83%（95% CI，77%-89%）。UCLI 后发现平均责任失分、保送、每局安打增加，投球局数减少，快球速度下降。
低水平、高偏倚证据表明，无论 UCLI 的治疗类型如何，总体 RTS 比例均高于 RTSP。尽管 RTS 比例在各个比赛水平上保持一致，但专业球员的 RTSP 比例较低，特别是小联盟球员与大学生和高中生球员相比。大多数研究发现术后投球表现明显下降。
