Department of Orthopaedic Surgery and Sports Medicine, University of Florida, Gainesville, Florida, U.S.A.
College of Medicine, University of Florida, Gainesville, Florida, U.S.A.
Arthroscopy. 2024 Jul;40(7):1997-2006.e1. doi: 10.1016/j.arthro.2024.01.033. Epub 2024 Feb 8.
To evaluate return to play (RTP) and return to same level of play (RTSP) rates as well as preoperative and postoperative in-game performance metrics in baseball pitchers who underwent ulnar collateral ligament reconstruction (UCLR). Secondarily, this review sought to assess outcomes based on primary versus revision UCLR as well as level of competition.
This review was performed using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed/MEDLINE, Embase, Web of Science, and Cochrane Database of Systematic Reviews were queried to identify articles evaluating UCLR in baseball players between January 2002 and October 2022. Data included RTP, RTSP, and performance metrics including earned run average, innings pitched, walks and hits per inning pitched, batting average against, strikeouts per 9 innings, walks per 9 innings, percentage of fastballs thrown, and average fastball velocity. The Methodological Index for Non-randomized Studies criteria were used for quality assessment.
Analysis included 25 articles reporting on 2,100 elbows. After primary UCLR, RTP ranged from 336 to 615 days (57% to 100% achieved) and RTSP ranged from 330 to 513 days (61% to 95%). After revision UCLR, RTP ranged from 381 to 631 days (67% to 98%) and RTSP ranged from 518 to 575 days (42% to 78%). When stratifying primary UCLR outcomes by competitive level, RTP and RTSP ranged respectively from 417 to 615 days (75% to 100%) and 513 days (73% to 87%) for Major League Baseball only, 409 to 615 days (57% to 100%) and 470 to 513 days (61% to 95%) for Major League Baseball plus Minor League Baseball, and 336 to 516 days (73% to 85%) and 330 days (55% to 74%) for college plus high school. Heterogeneity was seen in postoperative sports performance metrics.
Although more than half of baseball players appear able to RTP after primary and revision UCLR, RTSP rates after revision UCLR were as low as 42% in the literature. Preoperative and postoperative performance metrics varied.
Level IV, systematic review of Level II-IV studies.
评估接受 UCLR 的棒球投手的重返赛场（RTP）和重返同一比赛水平（RTSP）率，以及术前和术后比赛表现指标。其次，本综述旨在根据 UCLR 的初次手术与翻修手术以及比赛级别评估结果。
本综述按照系统评价和荟萃分析的首选报告项目进行。检索 PubMed/MEDLINE、Embase、Web of Science 和 Cochrane 系统评价数据库，以确定 2002 年 1 月至 2022 年 10 月期间评估棒球运动员 UCLR 的文章。数据包括 RTP、RTSP 和表现指标，包括平均责任失分、投球局数、每局投球的安打和保送数、自责分率、每 9 局的三振数、每 9 局的保送数、投出的快球百分比和平均快球速度。使用非随机研究方法学指数评估质量。
分析包括 25 篇报告了 2100 个肘部的文章。初次 UCLR 后，RTP 范围为 336 至 615 天（57%至 100%实现），RTSP 范围为 330 至 513 天（61%至 95%）。初次 UCLR 翻修术后，RTP 范围为 381 至 631 天（67%至 98%），RTSP 范围为 518 至 575 天（42%至 78%）。当按比赛级别对初次 UCLR 结果进行分层时，RTP 和 RTSP 分别为美国职棒大联盟（MLB）仅有 417 至 615 天（75%至 100%）和 513 天（73%至 87%），MLB 和小联盟（MiLB）共有 409 至 615 天（57%至 100%）和 470 至 513 天（61%至 95%），大学和高中共有 336 至 516 天（73%至 85%）和 330 天（55%至 74%）。术后运动表现指标存在异质性。
尽管大多数棒球运动员似乎能够在初次和翻修 UCLR 后重返赛场，但翻修 UCLR 后 RTSP 的比例在文献中低至 42%。术前和术后的表现指标有所不同。
IV 级，对 II-IV 级研究的系统评价。
