Return to Sport and Performance Outcomes after Isolated Posterior Labral Repair in Professional Baseball Players.

Purpose: To report the return to sport (RTS) rate, RTS time, and performance outcomes in professional baseball pitchers and position players who underwent isolated posterior labrum repair.

Methods: The MLB Health and Injury Tracking System (HITS) database was queried for all major league and minor league baseball players who underwent isolated posterior labrum repair from 2011-2022. Players were excluded if they underwent labrum débridement instead of repair, if they underwent concomitant SLAP or anterior labrum repair, or if they had multi-directional instability. Outcomes of interest included RTS rate, RTS time, workload statistics, and performance outcomes. Outcomes were compared between pitchers and position players, with further sub-analyses between starting vs. relief pitchers as well as between outfielders/infielders/catchers.

Results: Overall, 133 professional baseball players including 78 pitchers and 55 position players were included. Position players were able to RTS at a higher rate than pitchers (91.0% vs. 74.5%, p=0.020) and were able to RTS sooner (251 days vs. 330 days, p<0.001) than pitchers. RTS rate did not differ between starting and relief pitchers (76.2% vs. 69.2%, respectively, p=0.719), however starting pitchers took longer to RTS than relief pitchers (348 days vs. 268 days, p=0.013). Position players who underwent repair of the throwing shoulder returned to sport 74 days later (296 days vs. 222 days, p<0.001) than position players who underwent repair of the non-throwing shoulder, and position players who underwent repair of the trail (facing the catcher) batting shoulder returned to sport 96 days later (317 vs. 221 days, p<0.001) than position players who underwent repair of the lead (facing the pitcher) batting shoulder. Pitching workload returned to baseline by the second season postoperatively.

Conclusion: Professional baseball pitchers are able to return to sport less frequently and take longer to return to sport than professional baseball position players. Undergoing repair of the throwing or trail batting shoulder can delay return to sport by several months. Pitching workload returned to baseline by the second season postoperatively.