McKnight Braden, Heckmann Nathanael D, Chen Xiao T, Hindoyan Kevork, Hill J Ryan, Goldbeck Graham, Omid Reza, Hatch George F Rick, Charlton Timothy P
Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, California, USA.
Department of Orthopaedic Surgery, Washington University in St Louis, St Louis, Missouri, USA.
Orthop J Sports Med. 2020 Dec 16;8(12):2325967120968530. doi: 10.1177/2325967120968530. eCollection 2020 Dec.
Ulnar collateral ligament (UCL) reconstruction is frequently performed on Major League Baseball (MLB) pitchers. Previous studies have investigated the effects of UCL reconstruction on fastball and curveball velocity, but no study to date has evaluated its effect on fastball accuracy or curveball movement among MLB pitchers.
PURPOSE/HYPOTHESIS: The primary purpose of this study was to determine the effects of UCL reconstruction on fastball accuracy, fastball velocity, and curveball movement in MLB pitchers. Our hypothesis was that MLB pitchers who underwent UCL reconstruction would return to their presurgery fastball velocity, fastball accuracy, and curveball movement. The secondary purpose of this study was to determine which factors, if any, were predictive of poor performance after UCL reconstruction.
Case-control study; Level of evidence, 3.
MLB pitchers who underwent UCL reconstruction surgery between 2011 and 2012 were identified. Performance data including fastball velocity, fastball accuracy, and curveball movement were evaluated 1 year preoperatively and up to 3 years of play postoperatively. A repeated-measures analysis of variance with a Tukey-Kramer post hoc test was used to determine statistically significant changes in performance over time. Characteristic factors and presurgery performance statistics were compared between poor performers (>20% decrease in fastball accuracy) and non-poor performers.
We identified 56 pitchers with a total of 230,995 individual pitches for this study. After exclusion for lack of return to play (n = 14) and revision surgery (n = 3), 39 pitchers were included in the final analysis. The mean presurgery fastball pitch-to-target distance was 32.9 cm. There was a statistically significant decrease in fastball accuracy after reconstruction, which was present up to 3 years postoperatively ( = .007). The mean presurgery fastball velocity of 91.82 mph did not significantly change after surgery ( = .194). The mean presurgery curveball movement of 34.49 cm vertically and 5.89 cm horizontally also did not change significantly ( = .937 and .161, respectively).
Fastball accuracy among MLB pitchers significantly decreased after UCL reconstruction for up to 3 years postoperatively. There were no statistically significant differences in characteristic factors or presurgery performance statistics between poor and non--poor performers.
美国职业棒球大联盟（MLB）投手经常进行尺侧副韧带（UCL）重建手术。以往研究调查了UCL重建对快球和曲线球速度的影响，但迄今为止尚无研究评估其对MLB投手快球准确性或曲线球运动轨迹的影响。
目的/假设：本研究的主要目的是确定UCL重建对MLB投手快球准确性、快球速度和曲线球运动轨迹的影响。我们的假设是，接受UCL重建的MLB投手将恢复到术前的快球速度、快球准确性和曲线球运动轨迹。本研究的次要目的是确定哪些因素（如果有的话）可预测UCL重建后表现不佳。
病例对照研究；证据等级，3级。
确定2011年至2012年间接受UCL重建手术的MLB投手。对术前1年及术后长达3年的比赛中的表现数据进行评估，包括快球速度、快球准确性和曲线球运动轨迹。采用重复测量方差分析和Tukey-Kramer事后检验来确定表现随时间的统计学显著变化。比较表现不佳者（快球准确性下降>20%）和非表现不佳者之间的特征因素和术前表现统计数据。
本研究共纳入56名投手，总计230,995次投球。排除未重返赛场者（n = 14）和翻修手术者（n = 3）后，最终分析纳入39名投手。术前快球投球至目标的平均距离为32.9厘米。重建后快球准确性有统计学显著下降，术后3年仍存在（P = .007）。术前快球平均速度为91.82英里/小时，术后无显著变化（P = .194）。术前曲线球垂直方向平均运动轨迹为34.49厘米，水平方向为5.89厘米，也无显著变化（分别为P = .937和P = .161）。
MLB投手在UCL重建后，快球准确性在术后长达3年显著下降。表现不佳者和非表现不佳者在特征因素或术前表现统计数据上无统计学显著差异。
