Steffes Matthew J, Heaps Braiden M, ElAttrache Neal S, Haselman William Tyler
Cedars-Sinai Kerlan-Jobe Institute, Los Angeles, California, USA.
Orthop J Sports Med. 2022 May 6;10(5):23259671221092728. doi: 10.1177/23259671221092728. eCollection 2022 May.
Rerupture of the reconstructed ulnar collateral ligament (UCL) is becoming more frequent at the professional level of baseball. However, there is no literature describing outcomes after UCL graft repair.
To evaluate rerupture rate, return to play, performance upon return, and patient-reported outcomes after a novel UCL graft repair technique.
Case series; Level of evidence, 4.
All included patients underwent UCL graft repair after a previous UCL reconstruction, pitched in at least 1 professional baseball game before repair, and were at least 2 years postprocedure within the same 10-year time period. The authors evaluated patient characteristics and performance metrics, including wins, losses, win percentage, earned run average, innings pitched, walks and hits per inning pitched, for the 2 seasons before and after the procedure. Patients were contacted to assess UCL rerupture, timing of return to sport, current level of competition, Conway score, and Kerlan-Jobe Orthopaedic Clinic (KJOC) Shoulder and Elbow Score.
Six players met the inclusion criteria. All had proximal UCL graft ruptures and underwent flexor-pronator tendon repair in combination with graft repair. At a mean (±SD) follow-up of 56.7 ± 37.8 months, no reruptures were encountered, and the mean KJOC score was 87.9 ± 14.6. Of the 6 pitchers who underwent UCL graft repair, 4 (67%) returned to professional pitching at a mean of 17 ± 6 months. Three of the 6 (50%) achieved an excellent Conway score, signifying a return to prior level of sport. There was no significant difference in demographic or preoperative pitching performance metrics between players who did and did not return to pitching. For those players who returned to professional pitching, there was no significant difference between preprocedure and postprocedure performance statistics.
Repair of the UCL graft appears to yield comparable rates of return to play and performance with revision UCL reconstruction. This technique serves as a viable alternative for proximal avulsion ruptures of the UCL graft.
在职业棒球领域，重建的尺侧副韧带（UCL）再次断裂正变得越来越常见。然而，尚无文献描述UCL移植修复后的结果。
评估一种新型UCL移植修复技术后的再断裂率、重返赛场情况、重返后的表现以及患者报告的结果。
病例系列；证据等级，4级。
所有纳入患者均在先前UCL重建后接受了UCL移植修复，在修复前至少参加过1场职业棒球比赛，且在同一10年时间段内术后至少2年。作者评估了患者特征和表现指标，包括手术前后两个赛季的胜场数、负场数、胜率、自责分率、投球局数、每局投球时的保送和安打数。与患者联系以评估UCL再断裂情况、重返运动的时间、当前比赛水平、康威评分以及克伦-乔布骨科诊所（KJOC）肩肘评分。
6名球员符合纳入标准。所有患者均为近端UCL移植断裂，并接受了屈肌-旋前圆肌肌腱修复联合移植修复。平均（±标准差）随访56.7±37.8个月时，未发生再断裂，平均KJOC评分为87.9±14.6。在接受UCL移植修复的6名投手中，4名（67%）平均在17±6个月后重返职业投球。6名中的3名（50%）获得了优秀的康威评分，表明恢复到了先前的运动水平。重返投球和未重返投球的球员在人口统计学或术前投球表现指标上无显著差异。对于那些重返职业投球的球员，术前和术后的表现统计数据无显著差异。
UCL移植修复似乎能产生与翻修UCL重建相当的重返赛场率和表现。该技术是UCL移植近端撕脱断裂的一种可行替代方法。
