Epidemiology of Elbow Medial Ulnar Collateral Ligament Surgeries in Major and Minor League Baseball Pitchers: A Descriptive Study of 2281 Cases.

IF 2.4 3区医学 Q2 ORTHOPEDICS

Orthopaedic Journal of Sports Medicine Pub Date : 2025-07-07 eCollection Date: 2025-07-01 DOI:10.1177/23259671251352199

Fabien Meta, Keith Meister, Timothy B Griffith, Stan Conte, Peter N Chalmers, Sophia Mavrommatis, Sean C Clark, Elizabeth Hebert, Christopher L Camp

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引用次数: 0

Abstract

Background: Injuries of the medial ulnar collateral ligament (MUCL) among baseball pitchers are increasing. Surgical treatment is evolving to optimize outcomes.

Purpose/hypothesis: This study's purpose was to highlight trends in MUCL repair and reconstruction in professional pitchers, describe outcomes such as return to any level of play (RTP), and identify factors impacting these outcomes. It was hypothesized that primary and revision MUCL surgery is increasing, with revision surgery requiring greater RTP time.

Study design: Case series; Level of evidence, 4.

Methods: The Major League Baseball (MLB) Health and Injury Tracking System database was used to procure data during the study period (2010-2023). All professional pitchers who underwent MUCL surgery during this period were included. RTP was defined as a pitcher returning to at least 1 professional game after index surgery. Return to the same level of play (RTSL) was defined as return to at least 1 game in the same league of play as before surgery. Because of the coronavirus pandemic, the year 2020 was considered an outlier and omitted from time-trend analysis.

Results: A total of 2281 pitchers who underwent MUCL surgery during the study period were included for analysis. The number of MUCL surgeries for pitchers increased yearly (R ² = 0.821; P < .001), as did the number of reconstructions with internal brace augmentation (R ² = 0.896; P < .001). The RTP rate for MLB pitchers was significantly higher than the RTSL rate (93% vs 71%; P < .001). This difference was not observed in Minor League Baseball (MiLB) pitchers (RTP 76% vs RTSL 74%; P = .142). RTP rates after revision surgery were lower than those after primary surgery (71% vs 80%; P = .020). The mean time to RTP was shorter (470 ± 135 days) than the mean time to RTSL (499 ± 153 days; P < .001).

Conclusion: The incidence of MUCL surgery and revision surgery is increasing among professional pitchers. Overall, 79% of pitchers returned to any level of play at a mean of 470 days, while 74% returned to the same level of play at a mean of 499 days, but this varied based on level of play. This study will guide athlete expectations and surgeon decision-making.

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2281例棒球大、小联盟投手肘关节内侧尺侧副韧带手术的流行病学研究。

背景：棒球投手的内侧尺侧副韧带（MUCL）损伤呈上升趋势。外科治疗正在不断发展以优化结果。目的/假设：本研究的目的是强调职业投手MUCL修复和重建的趋势，描述诸如恢复任何比赛水平（RTP）等结果，并确定影响这些结果的因素。假设原发性和翻修性MUCL手术正在增加，翻修性手术需要更长的RTP时间。研究设计：病例系列；证据等级，4级。方法：使用美国职业棒球大联盟（MLB）健康与伤害追踪系统数据库获取研究期间（2010-2023年）的数据。所有在此期间接受过MUCL手术的职业投手都被包括在内。RTP被定义为投手在食指手术后至少恢复一场职业比赛。恢复到相同水平的比赛（RTSL）被定义为在手术前的相同联赛中至少恢复一场比赛。由于冠状病毒大流行，2020年被认为是一个异常值，在时间趋势分析中被省略。结果：研究期间共纳入2281名接受MUCL手术的投手进行分析。投手MUCL手术次数逐年增加(r2 = 0.821；P < .001)，内支撑增强重建次数(r2 = 0.896；P < 0.001)。MLB投手的RTP率显著高于RTSL率(93% vs 71%；P < 0.001)。这种差异在美国职业棒球小联盟（MiLB）的投手中没有观察到(RTP 76% vs RTSL 74%；P = .142)。翻修手术后RTP率低于初次手术后(71% vs 80%；P = .020)。RTP平均时间（470±135 d）短于RTSL平均时间（499±153 d）；P < 0.001)。结论：在职业投手中，MUCL手术及翻修手术的发生率呈上升趋势。总体而言，79%的投手在平均470天内恢复到任何水平的比赛，而74%的投手在平均499天内恢复到相同的比赛水平，但这取决于比赛水平。这项研究将指导运动员的期望和外科医生的决策。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Orthopaedic Journal of Sports Medicine Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

7.70%

发文量

876

审稿时长

12 weeks

期刊介绍： The Orthopaedic Journal of Sports Medicine (OJSM), developed by the American Orthopaedic Society for Sports Medicine (AOSSM), is a global, peer-reviewed, open access journal that combines the interests of researchers and clinical practitioners across orthopaedic sports medicine, arthroscopy, and knee arthroplasty. Topics include original research in the areas of: -Orthopaedic Sports Medicine, including surgical and nonsurgical treatment of orthopaedic sports injuries -Arthroscopic Surgery (Shoulder/Elbow/Wrist/Hip/Knee/Ankle/Foot) -Relevant translational research -Sports traumatology/epidemiology -Knee and shoulder arthroplasty The OJSM also publishes relevant systematic reviews and meta-analyses. This journal is a member of the Committee on Publication Ethics (COPE).