Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA; Minnesota Twins Baseball Club, Minneapolis, MN, USA.
Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA.
J Shoulder Elbow Surg. 2021 May;30(5):e245-e250. doi: 10.1016/j.jse.2020.08.041. Epub 2020 Sep 17.
As the incidence of ulnar collateral ligament reconstruction (UCLR) surgery continues to rise, an improved understanding of baseball pitchers' perspectives on the postoperative recovery process and return to pitching is needed. The purpose of this study was to analyze pitchers' perspectives on recovery after UCLR.
During the 2018 baseball season, an online questionnaire was distributed to the certified athletic trainers of all 30 Major League Baseball (MLB) organizations. These athletic trainers then administered the survey to all players within their organization including MLB and 6 levels of Minor League Baseball. MLB or Minor League Baseball pitchers who had previously undergone UCLR and participated in a rehabilitation program (or were currently participating in one at time of the survey) were included in the study.
There were 530 professional pitchers who met inclusion criteria. The majority (81%) of pitchers began rehabilitation within 2 weeks of surgery, with 51% beginning within 1 week. The majority of pitchers began a long-toss throwing program at 5 and 6 months after surgery (27% and 21%), with 52% making their first throw off a mound between 7 and 9 months. The number of pitchers who participated in a weighted ball throwing program decreased significantly after surgery (20%-11%, P < .001). After UCLR, 56% of pitchers reported no changes regarding pitching mechanics or types of pitches thrown, 42% reported changed mechanics, and only 3% either decreased or stopped throwing a certain pitch type. Overall, 54% believed that their current throwing velocity was faster than their velocity before ulnar collateral ligament injury. Twenty percent of pitchers reported experiencing a setback that resulted in temporary stoppage of their rehabilitation program, the most common reason being flexor tightness or tendonitis (53%). Seventy-six percent reported that they were not concerned about sustaining another elbow injury; however, significantly less (61%; P < .001) stated that they would have UCLR again if necessary.
Although UCLR is generally reported to have excellent clinical outcomes, 20% of pitchers experienced a significant setback during their rehabilitation and only 61% of pitchers, having gone through UCLR and the subsequent recovery, would be willing to undergo revision surgery and repeat the rehabilitation process if it were to become necessary. In addition, 42% of pitchers felt that they had to alter their throwing mechanics to return to pitching. Surgeons and athletic trainers should aim to understand the UCLR recovery process from the pitchers' perspective to better counsel future patients recovering from UCLR.
随着 UCLR 手术的发病率不断上升，人们需要更好地了解棒球投手对术后恢复过程和重返投球的看法。本研究的目的是分析投手对 UCLR 后的恢复情况。
在 2018 年棒球赛季期间，向所有 30 个美国职业棒球大联盟 (MLB) 组织的认证运动训练师分发了在线问卷。这些运动训练师随后向其组织内的所有球员进行了调查，包括 MLB 和 6 个级别的小联盟棒球。曾经接受过 UCLR 并参加过康复计划（或在调查时正在参加康复计划）的 MLB 或小联盟棒球投手被纳入研究。
有 530 名符合条件的职业投手。大多数（81%）投手在手术后 2 周内开始康复，其中 51%在 1 周内开始康复。大多数投手在手术后 5 个月和 6 个月开始进行长投投掷计划（分别为 27%和 21%），52%的人在 7 个月至 9 个月之间首次从投球台上投球。手术后参与加权球投掷计划的投手数量明显减少（20%-11%，P<.001）。在 UCLR 后，56%的投手报告说投球机制或投球类型没有变化，42%的投手报告说投球机制发生了变化，只有 3%的投手减少或停止投掷某种类型的投球。总体而言，54%的投手认为他们目前的投掷速度比 UCLR 前更快。20%的投手报告说他们经历了一次挫折，导致他们的康复计划暂时停止，最常见的原因是屈肌紧张或肌腱炎（53%）。76%的投手表示他们不担心再次肘部受伤；然而，明显较少（61%；P<.001）的投手表示，如果有必要，他们将再次接受 UCLR。
尽管 UCLR 通常被报道具有出色的临床效果，但 20%的投手在康复过程中经历了重大挫折，只有 61%的投手在经历过 UCLR 及其随后的康复后，愿意接受修正手术并再次经历康复过程，如果有必要的话。此外，42%的投手觉得他们不得不改变投球机制才能重返投球。外科医生和运动训练师应该从投手的角度理解 UCLR 的恢复过程，以便更好地为接受 UCLR 康复的未来患者提供咨询。
