Department of Orthopedic Surgery, Colorado Permanente Medical Group, Kaiser Permanente, Lafayette, Colorado, USA.
Department of Orthopaedic Surgery, University of Utah, Salt Lake City, Utah, USA.
Am J Sports Med. 2024 Jun;52(7):1692-1699. doi: 10.1177/03635465241243244. Epub 2024 May 4.
Thoracic outlet syndrome (TOS) remains a rare diagnosis but is being recognized as a cause of upper extremity dysfunction in professional baseball players.
PURPOSE/HYPOTHESIS: The purpose was to determine performance and return-to-play (RTP) outcomes in professional baseball players after surgical treatment of TOS. The hypothesis was that there would be a high RTP rate in professional baseball players after TOS surgery with no statistical differences in performance between pitchers who had TOS surgery and matched controls.
Cohort study; Level of evidence, 3.
All professional baseball players who underwent surgical treatment of TOS between 2010 and 2017 were identified using the Major League Baseball Health and Injury Tracking System database. Demographic and performance data (before and after surgery) for each player were recorded. Performance variables were then compared between players who underwent TOS surgery and matched controls. The matching criteria were no history of previous surgeries on affected arm, age at time of surgery, throwing side, level of play (Major or Minor League Baseball), and years of experience playing professional baseball.
Overall, 52 players underwent surgery for TOS, of whom 46 (88%) were pitchers. The type of TOS was neurogenic in 69% and venous in 29%. One player had arterial TOS. After TOS surgery, 79% of players returned to play at the same or higher level (RTSP) by 9.5 months and played ≥3 years after surgery. No differences were found in RTSP rate based on the type of TOS. No statistical difference was found in RTP rates between major and minor league players. Pitchers had a 76% RTSP, which was similar to the natural attrition for control pitchers ( = .874). After TOS surgery, pitchers saw a decline in several performance metrics, but these declines were not different from those of control pitchers, indicating that the decline in performance after TOS surgery was no faster than is seen in healthy professional pitchers as they age.
The rate of RTSP after surgery for TOS in professional baseball players was 79%. There was no difference in RTP based on the type of TOS. Pitchers who underwent surgery for TOS had no significant differences in pitching performance metrics after surgery compared with matched controls.
胸廓出口综合征（TOS）仍然是一种罕见的诊断，但它被认为是职业棒球运动员上肢功能障碍的原因。
目的/假设：目的是确定 TOS 手术后职业棒球运动员的表现和重返赛场（RTP）结果。假设是 TOS 手术后职业棒球运动员的 RTP 率会很高，且接受 TOS 手术的投手与匹配对照之间的表现没有统计学差异。
队列研究；证据水平，3 级。
使用美国职棒大联盟健康和伤害跟踪系统数据库，确定 2010 年至 2017 年间接受 TOS 手术治疗的所有职业棒球运动员。记录每位运动员的人口统计学和表现数据（手术前后）。然后将接受 TOS 手术的运动员与匹配对照之间的表现变量进行比较。匹配标准为：患侧手臂无既往手术史、手术时的年龄、投球手、比赛级别（大联盟或小联盟）和职业棒球经验年限。
总体而言，52 名运动员因 TOS 接受手术，其中 46 名（88%）为投手。69%的 TOS 类型为神经源性，29%为静脉性。1 名运动员为动脉性 TOS。TOS 手术后，79%的运动员在 9.5 个月内以相同或更高水平（RTSP）重返赛场，并在手术后至少 3 年继续比赛。根据 TOS 的类型，RTSP 率没有差异。大联盟和小联盟球员的 RTP 率没有差异。投手的 RTSP 为 76%，与对照投手的自然淘汰率相似（=0.874）。TOS 手术后，投手的几项表现指标下降，但与对照投手相比，这些下降没有差异，表明 TOS 手术后的表现下降速度与健康职业投手随着年龄增长的下降速度一样快。
TOS 手术后职业棒球运动员的 RTSP 率为 79%。TOS 类型对 RTP 没有影响。接受 TOS 手术的投手与匹配对照相比，手术后在投球表现指标上没有显著差异。
