Return to Play in Adolescent Baseball Players After SLAP Repair.

Abstract

Background: Superior labral anterior-posterior (SLAP) tears are increasingly common shoulder injuries in adolescent athletes participating in overhead throwing.

Purpose/hypothesis: The purpose was to evaluate outcomes, satisfaction, and competitive level progression in adolescent baseball athletes who underwent SLAP repair. It was hypothesized that pitchers may experience inferior outcomes compared with nonpitchers, and collegiate athletes may have decreased outcomes compared with lower-competition-level athletes.

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

Methods: Patients aged 10 to 19 years who underwent SLAP repair from 2008 to 2018 with a minimum 2-year follow-up were identified from a single institution's medical records. Nonbaseball athletes and nonthrowing shoulders were excluded. Patients were contacted via telephone to complete patient-reported outcome (PROs) scores, including the Western Ontario Shoulder Instability Index (WOSI), Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow Score, 12-item Short Form Survey Mental Component Summary and Physical Component Summary, Single Assessment Numeric Evaluation, and a custom return-to-play (RTP) questionnaire.

Results: A total of 59 baseball players met the inclusion criteria, and 76.3% (45/59) were successfully contacted for follow-up. All patients were male, with a mean age of 17.4 ± 1.5 years (range, 14-19 years). The mean follow-up was 5.3 ± 2.6 years (range, 2.1-12.1 years). The overall RTP rate was 75.6% (34/45), with a mean time from surgery to initiation of throwing of 5.9 ± 2.0 months (range, 2-12 months) and a mean time of 11.3 ± 3.5 months (range, 6-22 months) until full competition. Athletes continued competitive baseball for a mean of 2.9 ± 1.9 years (range, 0.5-8.0 years) after surgery. At the time of final follow-up, 71.1% (32/45) of players had stopped playing baseball and 22% (10/45) attributed cessation to subjective shoulder limitations. No significant differences were found in RTP rates or PROs, although pitchers reported worse postoperative performance (P = .013).

Conclusion: Adolescent baseball players undergoing SLAP repair had favorable RTP rates and PROs, with no significant differences between pitchers and position players. Despite pitchers reporting worse postoperative performance, overall satisfaction rates were high. Adolescents who stopped playing baseball generally discontinued play for reasons other than postsurgical shoulder function. These findings can help orthopaedic surgeons set realistic expectations for adolescent baseball players undergoing SLAP repair.