Hadley Christopher J, Edelman David, Arevalo Alfonso, Patel Nimit, Ciccotti Michael G, Dodson Christopher C
Rothman Orthopaedic Institute, Philadelphia, Pennsylvania, USA.
Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Am J Sports Med. 2021 Apr;49(5):1355-1362. doi: 10.1177/0363546520934778. Epub 2020 Aug 13.
Ulnar collateral ligament (UCL) reconstruction is an established surgical technique to restore UCL deficiency, especially in the overhead throwing athlete. Over the past decade, the number of patients requiring UCL reconstruction has increased significantly, particularly in the adolescent patient population. Return-to-play rates after UCL reconstruction reported in the literature have ranged from 33% to 92%, and a recent systematic review noted a return-to-play rate of 89.40% in all high school athletes.
To evaluate the outcomes, particularly return-to-play rates and subjective outcome scores, of UCL reconstruction of the elbow in adolescent throwing athletes.
Systematic review.
A systematic review of the literature was conducted via the electronic databases Embase, PubMed, and Cochrane. Studies that reported on outcomes, particularly return-to-play rates, in adolescent throwing athletes met the inclusion criteria and were included in our analysis. Studies that did not report on adolescent throwing athletes and studies that reported on adolescent throwing athletes but did not specify the return-to-play outcomes for these athletes were excluded from our analysis.
Nine studies met the inclusion criteria and were included in this review. There were 404 baseball players and 10 javelin throwers included in our analysis. A total of 349 of the 414 patients (84.30%) were successfully able to return to play at the same level of competition or higher. Successful rates of return to prior performance ranged from 66.67% to 91.49% in our analysis. Javelin throwers had a mean 80.00% rate of return to prior performance, while baseball players had a mean return-to-play rate of 84.40%. Complications were evaluated for 8 (88.9%) studies and 283 (68.4%) patients. There were 11 (3.9%) reported complications and 5 (1.8%) reoperations.
The findings of this systematic review revealed that adolescent patients are generally able to return to their preinjury level of performance or higher with limited complications. Further investigation is necessary to determine long-term outcomes for return to play after UCL reconstruction of the elbow in adolescent throwing athletes.
尺侧副韧带（UCL）重建是一种成熟的手术技术，用于修复UCL损伤，尤其是在过头投掷运动员中。在过去十年中，需要进行UCL重建的患者数量显著增加，特别是在青少年患者群体中。文献报道的UCL重建后的重返比赛率在33%至92%之间，最近一项系统评价指出，所有高中运动员的重返比赛率为89.40%。
评估青少年投掷运动员肘部UCL重建的结果，特别是重返比赛率和主观结果评分。
系统评价。
通过电子数据库Embase、PubMed和Cochrane对文献进行系统评价。报告青少年投掷运动员结果，特别是重返比赛率的研究符合纳入标准，并纳入我们的分析。未报告青少年投掷运动员的研究以及报告了青少年投掷运动员但未具体说明这些运动员重返比赛结果的研究被排除在我们的分析之外。
九项研究符合纳入标准并纳入本评价。我们的分析纳入了404名棒球运动员和10名标枪运动员。414名患者中有349名（84.30%）成功能够回到相同或更高水平的比赛。在我们的分析中，恢复到之前表现的成功率在66.67%至91.49%之间。标枪运动员恢复到之前表现的平均率为80.00%，而棒球运动员的平均重返比赛率为84.40%。对8项（88.9%）研究和283名（68.4%）患者进行了并发症评估。报告了11例（3.9%）并发症和5例（1.8%）再次手术。
本系统评价的结果显示，青少年患者一般能够恢复到受伤前的表现水平或更高水平，并发症有限。有必要进一步研究以确定青少年投掷运动员肘部UCL重建后重返比赛的长期结果。
