Mastroianni Michael A, Kunes Jennifer A, El-Najjar Dany B, Obana Kyle K, Desai Sohil S, Morrissette Cole R, Alexander Frank J, Rondon Alexander J, Trofa David P, Popkin Charles A, Levine William N, Ahmad Christopher S
Columbia University Irving Medical Center/NewYork-Presbyterian Hospital, New York, New York, USA.
Am J Sports Med. 2025 Jan;53(1):104-114. doi: 10.1177/03635465241289142.
Even though return to play is important for Major League Baseball (MLB) pitchers and teams, return to performance after ulnar collateral ligament (UCL) surgery using several advanced analytic and pitch-tracking metrics has not been well studied.
To evaluate return to performance in MLB pitchers using modern advanced analytic and pitch-tracking metrics at 1, 2, and 3 seasons after UCL surgery.
Case series; Level of evidence, 4.
A retrospective analysis was performed on 129 MLB pitchers who underwent primary UCL reconstruction or repair between November 2017 and November 2023 and reported return-to-play and return-to-performance rates at 1, 2, and 3 seasons postoperatively. Return-to-performance data were then collected for 58 MLB pitchers who had at least 2 seasons of postoperative data using public sources affiliated with MLB and used in previous studies. Return-to-performance analysis consisted of paired and unpaired tests comparing preoperative and postoperative metrics. The percentage of pitchers who returned to their preinjury performance for each respective advanced analytic or pitch-tracking metric was also recorded for each season after surgery. Return to full performance, defined as a pitcher returning to form in each key metric including expected fielding independent pitching, FanGraphs wins above replacement (fWAR), velocity, fastball velocity, and spin rate, was also evaluated. Data on advanced analytics released in 2020 measuring the physical quality of pitches (Stuff+), command of the strike zone (Location+), and overall pitching ability (Pitching+) was also examined for the first time. Binary logistic regression was conducted to evaluate for any predictive factors of return to performance.
The mean age was 27.6 ± 3.0 years. 1.6% returned to play at 1 year, 71.9% at 2 years, and 82.0% at 3 years from reported date of surgery with a mean of 584 ± 194 days. At 3 seasons postoperatively, pitchers returned to performance in pitch count (55%), expected fielding independent pitching (68%), fWAR (48%), velocity (76%), fastball velocity (80%), horizontal movement (81%), vertical movement (66%), Stuff+ (78%), Location+ (89%), and Pitching+ (78%) at varying degrees. Only 3.9%, 11.8%, and 28.1% of pitchers returned to full performance by 1, 2, and 3 seasons postoperatively, respectively. Only an additional 19.3% of pitchers met 4 out of 5 full performance criteria. Binary logistic regression identified starting pitchers and preoperative faster velocity and older age as strong negative predictors of return to full performance.
Pitchers provided only half of their value to teams at 3 years postoperatively, despite presumably being physically recovered. Even though most pitchers regained their previous form in various pitching metrics, the majority of pitchers did not return to full form. Overall, being a starting pitcher was the strongest negative predictor of returning to full performance, followed by faster preoperative velocity and older age. The return-to-performance rate for each pitching metric improved season to season after returning from an injury. Despite returning to play at high rates, pitchers still needed time to recover their performance.
尽管重返赛场对美国职业棒球大联盟（MLB）投手和球队很重要，但使用多种先进分析和投球跟踪指标来评估尺侧副韧带（UCL）手术后的表现恢复情况尚未得到充分研究。
使用现代先进分析和投球跟踪指标评估MLB投手在UCL手术后1、2和3个赛季的表现恢复情况。
病例系列；证据等级，4级。
对2017年11月至2023年11月期间接受初次UCL重建或修复手术的129名MLB投手进行回顾性分析，并报告术后1、2和3个赛季的重返赛场率和表现恢复率。然后，使用与MLB相关的公开来源，收集了58名至少有2个赛季术后数据的MLB投手的表现恢复数据，并用于先前的研究。表现恢复分析包括比较术前和术后指标的配对和非配对检验。还记录了手术后每个赛季中，每个先进分析或投球跟踪指标恢复到受伤前表现的投手百分比。还评估了完全恢复表现的情况，即投手在每个关键指标上恢复到受伤前状态，包括预期防守独立投球、FanGraphs胜场超过替代值（fWAR）、投球速度、快球速度和旋转速率。还首次检查了2020年发布的关于投球物理质量（投球素质+）、好球区控制（位置+）和整体投球能力（投球+）的先进分析数据。进行二元逻辑回归以评估表现恢复的任何预测因素。
平均年龄为27.6±3.0岁。从手术报告日期起，1.6%的投手在1年时重返赛场，71.9%在2年时重返赛场，82.0%在3年时重返赛场，平均为584±194天。术后3个赛季，投手在投球数（55%）、预期防守独立投球（68%）、fWAR（48%）、投球速度（76%）、快球速度（80%）、水平移动（81%）、垂直移动（66%）、投球素质+（78%）、位置+（89%）和投球+（78%）方面不同程度地恢复了表现。术后1、2和3个赛季分别只有3.9%、11.8%和28.1%的投手恢复到完全表现。只有另外19.3%的投手满足5项完全表现标准中的4项。二元逻辑回归确定先发投手、术前更快的投球速度和年龄较大是完全恢复表现的强烈负预测因素。
尽管投手可能在身体上已经恢复，但术后3年他们为球队提供的价值仅为一半。尽管大多数投手在各种投球指标上恢复了之前的状态，但大多数投手并未完全恢复。总体而言，作为先发投手是完全恢复表现的最强负预测因素，其次是术前更快的投球速度和年龄较大。从伤病中恢复后，每个投球指标的表现恢复率逐季提高。尽管重返赛场的比例很高，但投手仍需要时间来恢复他们的表现。
