Hamer Tyler J, Chung Sunghoon, Rosen Adam B
Department of Biomechanics, University of Nebraska Omaha, Omaha, Nebraska, USA.
School of Health and Kinesiology, University of Nebraska Omaha, Omaha, Nebraska, USA.
Orthop J Sports Med. 2021 Mar 19;9(3):2325967120988736. doi: 10.1177/2325967120988736. eCollection 2021 Mar.
Ulnar collateral ligament (UCL) reconstruction (UCLR) and repair (UCLr) are the gold standards in the treatment of UCL injuries. Although return-to-play timelines after UCLR have been established, pitching biomechanical variables are speculated to change after surgical intervention.
PURPOSE/HYPOTHESIS: To synthesize the literature and investigate changes in pitching biomechanics in baseball pitchers after UCLR or UCLr. We hypothesized that differences in pitching biomechanics would be observed for both intra- and interpatient comparisons.
Systematic review; Level of evidence, 3.
We searched 4 electronic databases (PubMed, Web of Science, SCOPUS, and Sports Medicine & Education Index) from inception to February 2020. Data extracted included author and year of publication, study design, sample size, study population, and primary outcome variables. Meta-analysis was performed to produce random pooled effect sizes (▵).
We identified 1010 original articles for inclusion. A total of 5 studies were included in the systematic review; of these, 3 studies were included in the meta-analysis. No differences were found in shoulder range of motion (ROM) between post-UCLR and control pitchers (dominant arm external rotation ▵, 0.13°; 95% CI, -0.15° to 4.02°; = .36); dominant arm internal rotation ▵, -0.20°; 95% CI, -0.74° to 0.35°; = .48). Mean fastball velocity as well as pitches thrown decreased after UCLR in professional pitchers. Significant differences in elbow extension, elbow extension velocity, and shoulder internal rotation velocity were found among amateur pitchers.
The results of this systematic review and meta-analysis show that limited differences exist in pitchers before and after UCLR as well as in post-UCLR pitchers and healthy, age-matched controls. UCLR may influence throwing velocity, but it had no effect on either the throwing biomechanics or theROM of baseball pitchers. Although trends appear to be forming, further evidence is needed to understand the effect of UCLR on throwing biomechanics.
尺侧副韧带（UCL）重建术（UCLR）和修复术（UCLr）是治疗UCL损伤的金标准。尽管已经确定了UCLR后的重返赛场时间线，但据推测，手术干预后投球生物力学变量会发生变化。
目的/假设：综合文献并研究棒球投手在UCLR或UCLr后投球生物力学的变化。我们假设在患者内和患者间比较中均会观察到投球生物力学的差异。
系统评价；证据等级，3级。
我们检索了4个电子数据库（PubMed、科学网、Scopus和运动医学与教育索引），检索时间从建库至2020年2月。提取的数据包括作者和发表年份、研究设计、样本量、研究人群和主要结局变量。进行荟萃分析以得出随机合并效应量（▵）。
我们确定了1010篇纳入的原始文章。共有5项研究纳入系统评价；其中3项研究纳入荟萃分析。UCLR后投手与对照投手在肩部活动范围（ROM）方面未发现差异（优势臂外旋▵，0.13°；95%CI，-0.15°至4.02°；P = 0.36）；优势臂内旋▵，-0.20°；95%CI，-0.74°至0.35°；P = 0.48）。职业投手在UCLR后平均快球速度以及投球次数均下降。业余投手在肘部伸展、肘部伸展速度和肩部内旋速度方面存在显著差异。
本系统评价和荟萃分析结果表明，UCLR前后的投手以及UCLR后的投手与健康的、年龄匹配的对照之间存在有限差异。UCLR可能会影响投球速度，但对棒球投手的投球生物力学或ROM均无影响。尽管似乎正在形成趋势，但需要更多证据来了解UCLR对投球生物力学的影响。
