UCHealth Steadman Hawkins Clinic-Denver, Englewood, Colorado, USA.
Department of Orthopedics, Division of Sports Medicine and Shoulder Surgery, University of Colorado School of Medicine, Aurora, Colorado, USA.
Am J Sports Med. 2021 Apr;49(5):1137-1144. doi: 10.1177/0363546521996706. Epub 2021 Mar 15.
Medial ulnar collateral ligament (UCL) injuries are common among baseball players. There is sparse literature on long-term results after nonoperative treatment of UCL injuries in professional baseball players.
The primary purpose was to assess long-term follow-up on reinjury rates, performance metrics, rate of return to the same level of play or higher (RTP), and ability to advance to the next level of play in professional baseball players after nonoperative treatment of incomplete UCL injuries. The secondary aim was to perform a matched-pair comparison between pitchers treated nonoperatively and a control group without a history of UCL injuries.
Cohort study; Level of evidence, 3.
Twenty-eight professional baseball players (18 pitchers, 10 position players) treated nonoperatively were identified from a previous retrospective review of a single professional baseball organization between 2006 and 2011. UCL reinjury rates and player performance metrics were evaluated at long-term (minimum, 9 years) follow-up. Rates of RTP were calculated. A matched-pair comparison was made between the pitchers treated nonoperatively and pitchers without a history of UCL injuries.
Overall, 27 players (17 pitchers, 10 position players) were available for long-term follow-up at a mean follow-up of 12 years (SD, 2 years). The overall rate of RTP was 85% (23/27), with the rate of RTP being 82% (14/17) in pitchers and 90% (9/10) in position players. Of the 23 players who did RTP, 18 (78%) reached a higher level of play and 5 (21.7%) stayed at the same level. Of the 9 position players who did RTP, the median number of seasons played after injury was 4.5 (interquartile range, 3.3). Of the 14 pitchers who did RTP, the mean number of seasons played after injury was 5.8 (SD, 3.8). In the matched-pair analysis, no significant differences were observed in any performance metrics (P > .05). The overall reinjury rate was 11.1% (3/27), with no players requiring UCL reconstruction.
There was a high rate of RTP for professional baseball players treated nonoperatively for incomplete UCL injuries. Compared with a matched cohort with no history of UCL injury, professional baseball pitchers treated nonoperatively had similar performance metrics. Reinjury rates were low, and no player had reinjury requiring UCL reconstruction. Nonoperative treatment of incomplete UCL injuries in professional baseball players, specifically pitchers, is a viable treatment option in the long term.
棒球运动员中常见的是尺侧副韧带（UCL）损伤。关于职业棒球运动员 UCL 损伤非手术治疗的长期结果，文献报道较少。
主要目的是评估 UCL 损伤非手术治疗后职业棒球运动员再损伤率、表现指标、重返同级别或更高水平比赛（RTP）的比率以及晋级到下一级别比赛的能力。次要目的是对非手术治疗的投手与无 UCL 损伤史的对照组进行配对比较。
队列研究；证据水平，3 级。
从 2006 年至 2011 年期间，对某单一职业棒球队的一项回顾性研究中，确定了 28 名接受非手术治疗的职业棒球运动员（18 名投手，10 名野手）。在长期（至少 9 年）随访时，评估 UCL 再损伤率和运动员表现指标。计算 RTP 率。对非手术治疗的投手与无 UCL 损伤史的投手进行配对比较。
总体而言，在平均随访 12 年（SD，2 年）时，27 名运动员（17 名投手，10 名野手）可进行长期随访。总体 RTP 率为 85%（23/27），投手中 RTP 率为 82%（14/17），野手为 90%（9/10）。在 23 名 RTP 运动员中，18 名（78%）达到了更高的比赛水平，5 名（21.7%）保持在同一水平。在 9 名 RTP 的野手中，受伤后中位数参加比赛的赛季数为 4.5 个（四分位距，3.3）。在 14 名 RTP 的投手中，受伤后平均参加比赛的赛季数为 5.8 个（SD，3.8）。在配对分析中，在任何表现指标上均未观察到显著差异（P＞.05）。总体再损伤率为 11.1%（3/27），无运动员需要 UCL 重建。
对 UCL 损伤非手术治疗的职业棒球运动员，RTP 率较高。与无 UCL 损伤史的匹配队列相比，非手术治疗的职业棒球投手的表现指标相似。再损伤率较低，无运动员因 UCL 损伤需要重建。非手术治疗职业棒球运动员（尤其是投手）的 UCL 不完全损伤是一种长期可行的治疗选择。
