Lipa Daniel, Shivdasani Krishin, Scheidt Michael, Anderson Joshua, Salazar Dane, Garbis Nickolas
Department of Orthopaedic Surgery & Rehabilitation, Loyola University Health System, Maywood, Illinois, U.S.A.
Carle Illinois College of Medicine, University of Illinois Urbana-Champaign, Champaign, Illinois, U.S.A.
Arthrosc Sports Med Rehabil. 2024 Jul 17;7(1):100979. doi: 10.1016/j.asmr.2024.100979. eCollection 2025 Feb.
To use a publicly available Major League Baseball (MLB) game video to investigate whether pitch type and pitching elbow angle at peak valgus stress and at release point are associated with the odds of undergoing Tommy John surgery.
This case-control study compared pitchers who had undergone ulnar collateral ligament reconstruction to a matched control group of pitchers who had not undergone the surgery. Pitchers were selected based on inclusion in online baseball player and injury databases, including the MLB Health and Injury Tracking System, with those pitching fewer than 10 innings in MLB excluded. The experimental group included measurements from all pitchers before their ulnar collateral ligament injury who eventually had undergone Tommy John surgery since 2010. Greedy matching algorithm was used to select a matched cohort of pitchers based on age, height, weight, years in the MLB, hand dominance, pitching role (starter vs reliever), and average pitching velocity. Conditional logistic regression models were used to measure the association between pitch angle and log odds of receiving a Tommy John surgery.
There were 249 paired cases and controls (N = 498) included in the conditional logistic regression analysis. There was no statistically significant association between average elbow angle at peak valgus stress and the odds of undergoing Tommy John surgery (odds ratio, 1.02; 95% confidence interval, 0.99-1.03; = .14).
Peak valgus elbow angle, release point angles, and combinations of angles and specific pitches were not associated with an increased risk of undergoing Tommy John surgery.
Level III, observational study, case-control design.
利用公开可得的美国职业棒球大联盟（MLB）比赛视频，研究在最大外翻应力时和投球释放点的投球类型及投球手肘角度是否与接受汤米·约翰手术的几率相关。
本病例对照研究将接受尺侧副韧带重建的投手与未接受该手术的匹配对照组投手进行比较。投手是根据其被纳入在线棒球运动员和伤病数据库（包括MLB健康与伤病追踪系统）来选择的，排除了在MLB投球少于10局的投手。实验组包括自2010年以来最终接受了汤米·约翰手术的所有投手在尺侧副韧带损伤前的测量数据。采用贪婪匹配算法，根据年龄、身高、体重、在MLB的年限、惯用手、投球角色（先发投手与救援投手）以及平均投球速度，选择一组匹配的投手队列。使用条件逻辑回归模型来测量投球角度与接受汤米·约翰手术的对数几率之间的关联。
条件逻辑回归分析纳入了249对病例和对照（N = 498）。在最大外翻应力时的平均手肘角度与接受汤米·约翰手术的几率之间，没有统计学上的显著关联（优势比为1.02；95%置信区间为0.99 - 1.03；P = 0.14）。
最大外翻手肘角度、释放点角度以及角度与特定投球类型的组合，与接受汤米·约翰手术的风险增加无关。
III级，观察性研究，病例对照设计。
