Kerlan-Jobe Orthopaedic Clinic, Los Angeles, California, USA.
Am J Sports Med. 2018 Nov;46(13):3245-3253. doi: 10.1177/0363546518795670. Epub 2018 Sep 19.
Ulnar collateral ligament (UCL) reconstruction (UCLR) has shown reliable rates of return to play, with conflicting results on pitching performance after players' return.
To evaluate Major League Baseball (MLB) pitching performance before and after UCLR performed at a single institution.
Cohort study; Level of evidence, 3.
MLB pitchers (minor league players were excluded) who underwent UCLR at our institution between 2002 and 2016 were identified. Player information and return to play were determined including pitching level (MLB vs minor league) and total number of years played after surgery. Pitching performance statistics were evaluated for 3 years before surgery and for 3 years after returning to play including earned run average (ERA), walks plus hits per inning pitched (WHIP), innings pitched, wins above replacement, runs above replacement, and pitch velocity.
A total of 54 MLB pitchers were identified, with 46 primary and 8 revision reconstructions. The mean time to return to play was 13.8 months (primary reconstruction: 13.7 months). The majority returned to play with a 94% return rate (primary reconstruction: 96%), and 80% returned to MLB play (primary reconstruction: 82%). Three primary reconstructions required revision surgery. Pitchers played a mean of 3.2 years in MLB and 4.6 years total after surgery (39% still playing). Pitching workload and performance were maintained or improved after surgery. The preoperative ERA was 4.63 versus 4.13 after returning to play ( P = .268). Fastball velocity ( P = .032), ERA ( P = .003), and WHIP ( P = .001) worsened the first year after surgery and then improved the second year (ERA: 4.63 to 4.06 [ P = .380]; WHIP: 1.35 to 1.32 [ P = .221]; fastball velocity: 91.3 to 91.9 mph [ P = .097]). Compared with a matched control group, pitchers who had UCLR showed improvements or maintained performance after reconstruction including improved ERA ( P = .007), WHIP ( P = .025), and fastball velocity ( P = .006).
MLB players experienced a high rate of return to play and previous level of play after UCLR. Pitching workload was maintained after returning to play. Pitching performance initially decreased the first year after returning and then improved or reverted to previous levels after the first year from UCLR.
尺侧副韧带（UCL）重建（UCLR）的复出率可靠，而在运动员复出后投球表现的结果则存在冲突。
评估单机构 MLB 投手 UCLR 前后的投球表现。
队列研究；证据水平，3 级。
确定 2002 年至 2016 年间在我院接受 UCLR 的 MLB 投手（排除小联盟球员）。确定复出情况，包括投球水平（MLB 与小联盟）和术后投球年限。评估术前 3 年和术后 3 年的投球表现统计数据，包括平均自责分率（ERA）、每局被安打数和保送数（WHIP）、投球局数、胜场数、得分数和投球速度。
共确定 54 名 MLB 投手，其中 46 名接受初次重建，8 名接受翻修重建。平均复出时间为 13.8 个月（初次重建：13.7 个月）。94%（初次重建：96%）的患者恢复了 94%的投球率，80%（初次重建：82%）的患者恢复到 MLB 比赛。3 名初次重建患者需要翻修手术。投手平均在 MLB 中打球 3.2 年，术后总打球年限为 4.6 年（仍有 39%在打球）。术后投球工作量和表现保持或提高。术前 ERA 为 4.63，术后为 4.13（ P =.268）。术后第一年，投手的快球速度（ P =.032）、ERA（ P =.003）和 WHIP（ P =.001）恶化，第二年改善（ERA：4.63 到 4.06 [ P =.380]；WHIP：1.35 到 1.32 [ P =.221]；快球速度：91.3 到 91.9 英里/小时 [ P =.097]）。与匹配的对照组相比，接受 UCLR 的投手在重建后表现出改善或保持表现，包括 ERA（ P =.007）、WHIP（ P =.025）和快球速度（ P =.006）的改善。
MLB 球员在 UCLR 后复出率高，能达到之前的比赛水平。复出后投球工作量得以维持。投球表现最初在复出后的第一年下降，然后在第一年之后改善或恢复到 UCLR 前的水平。
