Department of Orthopedic Surgery, Henry Ford Hospital, Detroit, Michigan, U.S.A..
Department of Orthopedic Surgery, Henry Ford Hospital, Detroit, Michigan, U.S.A.
Arthroscopy. 2021 Mar;37(3):852-861. doi: 10.1016/j.arthro.2020.12.208. Epub 2020 Dec 24.
To determine the relation between medial elbow torque, as measured by wearable sensor technology, and adaptations of the medial elbow structures on dynamic ultrasound imaging in asymptomatic collegiate pitchers.
Thirty-four pitchers from National Collegiate Athletic Association Division II universities were eligible for preseason testing. The exclusion criteria included age younger than 18 years, history of surgery, non-pitcher, or current restrictions. Pitchers were fitted with a wearable sensor sleeve that recorded elbow torque, arm slot, arm speed, and arm rotation. Pitchers threw 5 fastballs in a standardized manner off the mound at game-speed effort. They also underwent dynamic ultrasound imaging of the elbow by a musculoskeletal sonographer, with standardized valgus loading. Images were deidentified, and measurements of the ulnar collateral ligament (UCL) and ulnohumeral joint space (UHJS), to assess elbow laxity, were performed by a musculoskeletal radiologist.
The final analysis included 28 pitchers with an average age of 20.1 years (standard deviation, 1.3 years; range, 18-23 years) and playing experience of 15.3 years (standard deviation, 1.8 years; range, 11-19 years). The dominant UCL thickness (P < .001), loaded UHJS (P = .039), and delta UHJS (P < .001) were significantly greater than the nondominant measurements. An inverse correlation was found between loaded UHJS and medial elbow torque (r = -0.4, P < .001). Additionally, every 1-mm increase in UHJS significantly reduced medial elbow torque by 2.27 Nm (P = .032) and arm slot by 8.8° (P = .019) and increased arm rotation by 5.3° (P = .043). Pitchers with a loaded UHJS of 4.4 mm or greater and delta UHJS of 1.25 mm or greater had significantly reduced medial elbow torque (P < .001). Pitchers with a UCL thickness of 1.65 mm or greater had significantly increased medial elbow torque (47.4 Nm vs 44.8 Nm, P = .006).
Pitchers with increased dynamic elbow laxity were found to experience reduced medial elbow torque while pitching. Additionally, pitchers with greater UCL thickness on ultrasound were found to experience increased medial elbow torque while pitching. This study's findings suggest a relation between anatomic adaptations found on ultrasound of the pitching elbow and medial elbow torque.
Level II, prospective cohort study.
确定在无症状大学生投手中，可穿戴传感器技术测量的内侧肘扭矩与内侧肘结构的适应之间的关系。
来自美国全国大学体育协会二级大学的 34 名投手可参加季前测试。排除标准包括年龄小于 18 岁、手术史、非投手或当前限制。投手佩戴可记录肘扭矩、臂槽、臂速和臂旋转的可穿戴传感器袖套。投手以比赛速度的努力从投球丘上以标准方式投掷 5 个快球。他们还接受了由肌肉骨骼超声医师进行的肘部动态超声检查，同时进行了标准的外翻加载。图像被去识别，由肌肉骨骼放射科医师对尺侧副韧带 (UCL) 和尺肱关节间隙 (UHJS) 进行测量，以评估肘部松弛度。
最终分析包括 28 名平均年龄为 20.1 岁（标准差为 1.3 岁；范围为 18-23 岁）、运动经验为 15.3 年（标准差为 1.8 年；范围为 11-19 年）的投手。优势 UCL 厚度（P<.001）、加载 UHJS（P=.039）和 delta UHJS（P<.001）明显大于非优势测量值。负载 UHJS 与内侧肘扭矩之间存在负相关关系（r=-0.4，P<.001）。此外，UHJS 每增加 1 毫米，内侧肘扭矩就会减少 2.27 Nm（P=.032），臂槽减少 8.8°（P=.019），臂旋转增加 5.3°（P=.043）。UHJS 加载值为 4.4 毫米或更大，delta UHJS 值为 1.25 毫米或更大的投手，内侧肘扭矩明显降低（P<.001）。UCL 厚度为 1.65 毫米或更大的投手，内侧肘扭矩明显增加（47.4 Nm 比 44.8 Nm，P=.006）。
研究发现，肘部动态松弛度增加的投手在投球时内侧肘扭矩降低。此外，超声检查 UCL 厚度较大的投手在投球时内侧肘扭矩增加。本研究的结果表明，投球肘超声检查发现的解剖学适应与内侧肘扭矩之间存在关系。
II 级，前瞻性队列研究。
