Department of Orthopedic Surgery, Stanford University, Redwood City, California.
Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, Michigan, U.S.A.
Arthroscopy. 2023 Aug;39(8):1905-1935. doi: 10.1016/j.arthro.2022.12.024. Epub 2022 Dec 29.
To summarize the incidence of injuries occurring in professional baseball and compare player outcomes reported in the literature.
We conducted a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines across 3 databases (PubMed, MEDLINE, Embase). Inclusion criteria were studies of injury incidences and/or injury outcomes on active Major League Baseball (MLB) athletes and studies published in the English language. Exclusion criteria were non-MLB players, case series and case report studies with a cohort of ≤3 players, and/or review articles.
A total of 477 articles were identified from the initial search of 3 databases, with 105 studies meeting inclusion criteria. Among these articles, the most common injuries studied were elbow (38%), shoulder (14%), hip/groin (11%), hand/wrist (7%), head/face (7%), knee (7%), spine (5%), and foot/ankle (3%). Injuries with the greatest incidence included hand/wrist (150.3 per year), hamstring (7.8-73.5 per year), ulnar collateral ligament (UCL) tears (0.23-26.8 per year), gastrocnemius strains (24.2 per year), and concussions (3.6-20.5 per year). Lowest rates of return to play were seen following shoulder labral tears (40%-72.5%), rotator cuff tears (33.3%-87%), and UCL tears (51%-87.9%). The injuries leading to most time away from sport included elbow UCL tears (average 90.3 days treated nonoperatively to 622.8 days following revision reconstruction), shoulder labral tears (average 315-492 days), and anterior cruciate ligament (ACL) tears (average 156.2-417.5 days). Following ACL tears, rotator cuff tears, shoulder labral tears, and hip femoroacetabular impingement requiring arthroscopy, athletes had a significantly lower workloads compared with before injury upon return to play.
Most published investigations focus on elbow injuries of the UCL, with variable return to play and mixed performance following surgery. UCL tears, shoulder labral tears, and ACL tears result in the most missed time. Upper-extremity injury such as shoulder labral tears, rotator cuff tears, and UCL tears had the poorest return to play rates. Workload was most affected following ACL reconstruction, rotator cuff repair, shoulder labral repair, and hip arthroscopy for femoroacetabular impingement.
Level IV, systematic review of level II-IV studies.
总结职业棒球运动员受伤的发生率，并比较文献中报告的球员结局。
我们使用 Preferred Reporting Items for Systematic Reviews and Meta-Analyses 指南，在 3 个数据库（PubMed、MEDLINE、Embase）中进行了系统综述。纳入标准为针对现役美国职业棒球大联盟（MLB）运动员的伤发生率和/或伤结局的研究，以及以英文发表的研究。排除标准为非 MLB 运动员、队列研究中包含的患者数≤3 例的病例系列和病例报告研究，以及综述文章。
从 3 个数据库的初始搜索中总共确定了 477 篇文章，其中 105 篇研究符合纳入标准。在这些文章中，研究最多的损伤是肘部（38%）、肩部（14%）、臀部/腹股沟（11%）、手部/腕部（7%）、头部/面部（7%）、膝盖（7%）、脊柱（5%）和足部/脚踝（3%）。发生率最高的损伤包括手部/腕部（150.3 例/年）、腘绳肌（7.8-73.5 例/年）、尺侧副韧带（UCL）撕裂（0.23-26.8 例/年）、跟腱拉伤（24.2 例/年）和脑震荡（3.6-20.5 例/年）。肩部盂唇撕裂（40%-72.5%）、肩袖撕裂（33.3%-87%）和 UCL 撕裂（51%-87.9%）的球员回归比赛的比例最低。导致运动员离开运动时间最长的损伤包括肘部 UCL 撕裂（非手术治疗平均 90.3 天，翻修重建后平均 622.8 天）、肩部盂唇撕裂（平均 315-492 天）和前交叉韧带（ACL）撕裂（平均 156.2-417.5 天）。ACL 撕裂、肩袖撕裂、肩部盂唇撕裂和需要关节镜检查的髋关节股骨髋臼撞击症后，运动员在重返赛场后的工作量明显低于受伤前。
大多数已发表的研究都集中在 UCL 的肘部损伤上，手术后的回归比赛和混合表现存在差异。UCL 撕裂、肩部盂唇撕裂和 ACL 撕裂导致的缺赛时间最长。肩部盂唇撕裂、肩袖撕裂和 UCL 撕裂等上肢损伤的回归比赛率最低。ACL 重建、肩袖修复、肩部盂唇修复和髋关节股骨髋臼撞击症关节镜检查后，工作量受影响最大。
IV 级，对 II-IV 级研究的系统评价。
