Arnold Michael T, Hart Christopher M, Greig Danielle E, Trikha Rishi, Gelabert Hugh A, Jones Kristofer J
Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
Department of Vascular Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
Orthop J Sports Med. 2022 Apr 21;10(4):23259671221079835. doi: 10.1177/23259671221079835. eCollection 2022 Apr.
Thoracic outlet syndrome (TOS) is a rare injury that affects Major League Baseball (MLB) pitchers and is often corrected with surgical resection of the first rib. There are limited return-to-play (RTP) data for this surgery in MLB pitchers.
It was hypothesized that MLB pitchers who undergo first rib resection for TOS will show (1) a high rate of RTP, (2) no difference in postoperative career length compared with controls, (3) no difference in pre- and postoperative performance, and (4) no difference in postoperative performance compared with controls.
Cohort study; Level of evidence, 3.
This retrospective cohort study evaluated MLB pitchers with neurogenic or vascular TOS who underwent rib resection surgery between January 1, 2001, and December 31, 2019. Players were identified through public injury reports from press releases, the MLB website, MLB team injury reports, and blogs. A demographics- and performance-matched control group was generated for comparison. Each player in the control group was given an index year that corresponded to the surgery year of the case group. Performance data included innings pitched (IP), games played (GP), earned run average (ERA), complete GP, shutouts, saves, hits, runs, home runs (HR), walks, strikeouts (K), walks plus hits per IP (WHIP), and earned runs (ER).
We identified 26 MLB pitchers who underwent rib resection for neurogenic or vascular TOS; 21 players (81%) had a successful RTP. Pitchers were 30 ± 3.6 years old at the time of surgery and had played 6.2 ± 3.5 seasons before undergoing surgery. Average postoperative career length was 3.1 ± 2.0 seasons, with an average time from surgery to RTP being 10 ± 4.7 months. Pitchers who RTP showed no significant differences in performance metrics compared with controls. Players pitch 0.94 ( < .05) more IP/GP in the season directly following RTP compared with the season before surgical intervention.
MLB pitchers undergoing rib resection for TOS demonstrated (1) high RTP rates following rib resection, (2) no difference in postoperative career length compared with controls, (3) improvement in postoperative performance, and (4) no difference in postoperative performance compared with controls.
胸廓出口综合征（TOS）是一种罕见的损伤，影响美国职业棒球大联盟（MLB）投手，通常通过第一肋骨手术切除来矫正。MLB投手中关于这种手术的重返赛场（RTP）数据有限。
假设接受TOS第一肋骨切除术的MLB投手将表现出（1）高RTP率，（2）与对照组相比术后职业生涯长度无差异，（3）术前和术后表现无差异，以及（4）与对照组相比术后表现无差异。
队列研究；证据级别，3级。
这项回顾性队列研究评估了2001年1月1日至2019年12月31日期间接受肋骨切除手术的患有神经源性或血管性TOS的MLB投手。通过新闻稿、MLB网站、MLB球队伤病报告和博客中的公开伤病报告来识别球员。生成一个人口统计学和表现匹配的对照组进行比较。对照组中的每个球员都被赋予一个与病例组手术年份相对应的索引年份。表现数据包括投球局数（IP）、比赛场次（GP）、自责分率（ERA）、完投场次、完封场次、救援成功次数、安打数、得分、本垒打数（HR）、保送数、三振数（K）、每局上垒率（WHIP）和自责分（ER）。
我们确定了26名接受神经源性或血管性TOS肋骨切除术的MLB投手；21名球员（81%）成功重返赛场。投手手术时的年龄为30±3.6岁，手术前平均效力6.2±3.5个赛季。术后平均职业生涯长度为3.1±2.0个赛季，从手术到重返赛场的平均时间为10±4.7个月。与对照组相比，成功重返赛场的投手在表现指标上没有显著差异。与手术干预前的赛季相比，球员在重返赛场后的直接赛季中每局投球局数（IP/GP）多0.94（<0.05）。
接受TOS肋骨切除术的MLB投手表现出（1）肋骨切除术后高RTP率，（2）与对照组相比术后职业生涯长度无差异，（3）术后表现有所改善，以及（4）与对照组相比术后表现无差异。
