Rothman Orthopaedic Institute, New York, New York, USA.
Hospital for Special Surgery, West Palm Beach, Florida, USA.
Am J Sports Med. 2020 Sep;48(11):2608-2612. doi: 10.1177/0363546520947090. Epub 2020 Aug 18.
The number of ulnar collateral ligament (UCL) tears in professional baseball players is increasing. UCL reconstruction (UCLR) is the treatment of choice in players with failed nonoperative treatment who wish to return to sports (RTS). It is unknown if UCL tear location influences the ability of players to RTS or affects their performance upon RTS.
PURPOSE/HYPOTHESIS: The purpose was to compare the RTS rate and performance upon RTS in professional baseball players who underwent UCLR based on UCL tear location (proximal vs distal). It was hypothesized that no difference in RTS rate or performance upon RTS will exist between players with proximal or distal UCL tears.
Cohort study; Level of evidence, 3.
All professional baseball players who underwent primary UCLR by a single surgeon between 2016 and 2018 were eligible for inclusion. Players with purely midsubstance tears or revision UCLR were excluded. Tear location was determined based on preoperative magnetic resonance imaging (MRI) and intraoperative findings. RTS rate and performance were compared between players with proximal versus distal UCL tears.
Overall, 25 pitchers (15 proximal and 10 distal tears) and 5 position players (2 proximal and 3 distal) underwent primary UCLR between 2016 and 2018. Of the 25 pitchers, 84% were able to RTS. Of the 5 position players, 80% were able to RTS. Among the total cohort of pitchers and position players, 12 out of 17 (71%) players with proximal tears were able to RTS, while of the 13 distal tears, 13 out of 13 (100%) players were able to RTS ( = .05). With regard to performance data, pitchers with distal tears had higher utilization postoperatively and, as such, allowed statistically more hits ( = .03), runs ( = .015), and walks ( = .021) postoperatively. However, the WHIP ([walks + hits]/innings pitched) was not different between players with proximal or distal tears, indicating that efficacy in games was not significantly different between groups.
Professional baseball players who sustain a distal UCL tear and undergo UCLR may be more likely to RTS than those who sustain a proximal UCL tear and undergo UCLR. Players with distal UCL tears who underwent UCLR saw higher utilization postoperatively than those with proximal UCL tears. Further work is needed in this area to confirm this result.
职业棒球运动员的 UCL 撕裂数量正在增加。对于非手术治疗失败、希望重返运动（RTS）的运动员，UCL 重建（UCLR）是首选治疗方法。尚不清楚 UCL 撕裂位置是否会影响运动员的 RTS 能力或影响他们的 RTS 后表现。
目的/假设：本研究旨在比较基于 UCL 撕裂位置（近端 vs 远端）接受 UCLR 的职业棒球运动员的 RTS 率和 RTS 后表现。假设近端或远端 UCL 撕裂的运动员在 RTS 率或 RTS 后表现上没有差异。
队列研究；证据水平，3 级。
所有由一名外科医生在 2016 年至 2018 年间进行初次 UCLR 的职业棒球运动员均符合入选条件。单纯的中体撕裂或 UCLR 翻修的运动员被排除在外。根据术前磁共振成像（MRI）和术中发现确定撕裂位置。比较近端和远端 UCL 撕裂的运动员之间的 RTS 率和表现。
共有 25 名投手（15 例近端撕裂和 10 例远端撕裂）和 5 名外野手（2 例近端撕裂和 3 例远端撕裂）在 2016 年至 2018 年间接受了 UCLR。在 25 名投手中，84%能够 RTS。在 5 名外野手中，80%能够 RTS。在投手和外野手的总队列中，17 名近端撕裂的运动员中有 12 名（71%）能够 RTS，而在 13 名远端撕裂的运动员中，13 名（100%）能够 RTS（=.05）。就表现数据而言，远端撕裂的投手术后使用率更高，因此术后允许更多的安打（=.03）、跑垒（=.015）和保送（=.021）。然而，近端和远端 UCL 撕裂的运动员之间的 WHIP（[保送+安打]/投球局数）没有差异，表明两组在比赛中的疗效没有显著差异。
与近端 UCL 撕裂相比，远端 UCL 撕裂且接受 UCLR 的职业棒球运动员可能更有可能 RTS。接受 UCLR 的远端 UCL 撕裂的运动员术后使用率高于近端 UCL 撕裂的运动员。需要在这一领域进一步研究以证实这一结果。
