Study: Pitching performance declines after UCL repair

SEATTLE — A study presented here at the American Orthopaedic Society for Sports Medicine Annual Meeting found that performance among elite baseball pitchers decreased following UCL reconstruction.

Despite there being conflicting research on the topic, “Most recently, Makhni found that there was a decline in performance, and that is consistent with what we found,” Robert A. Keller, MD, said.

Keller and colleagues reviewed the statistics for 168 major league pitchers with a minimum of 1-year Major League Baseball (MLB) experience who underwent UCL reconstruction. Metrics evaluated included earned run average (ERA), walks and hits per innings pitched (WHIP), win percentage, innings pitched, and salary for 3 years both before and after UCL reconstruction. Findings were compared with a control group of 178 age-matched MLB pitchers.

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Overall, 87% of the pitchers returned to the MLB level, however, the researchers noted a significant decline in ERA, WHIP, and innings pitched when compared with the athletes’ pre-reconstruction performance. Pitchers who underwent UCL reconstruction had a decline the season prior to diagnosis of an UCL injury in all statistical metrics. Both a multivariable generalized estimating equation and comparison with controls showed more MLB experience at an early age was a significant risk factor for UCL tear.

Approximately 60% of the pitchers who required UCL reconstruction had surgery during the first five seasons of their MLB career.

“Obviously more prospective studies are needed…but probably most important, we need to limit the rise of ulnar collateral reconstructions,” Keller said. —by Christian Ingram

Reference:

Keller RA. Paper #13. American Orthopaedic Society for Sports Medicine Annual Meeting; July 10-13, 2014; Seattle.

Disclosure: Keller has no relevant financial disclosures.