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Link may exist between revision UCL reconstruction and poorer performance among MLB pitchers
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ORLANDO, Fla. — There is likely a link between Major League Baseball pitchers who undergo revision ulnar collateral ligament reconstruction and their decreased postoperative durability and performance, according to results of a study presented at the American Academy of Orthopaedic Surgeons Annual Meeting.
Researchers used publicly available databases to evaluate all 235 Major League Baseball (MLB) pitchers who underwent primary and revision ulnar collateral ligament reconstruction (UCL) since 1999. Comparisons of in-game performance data were made before and after the procedure for pitchers who returned to a minimum of one MLB game following revision UCL reconstruction. These cohorts were then compared with controls matched by age and position (starter or relief pitcher).
Of the 235 pitchers evaluated, 31 (13.2%) underwent revision UCL reconstruction. Of these, 37% of pitchers had revision surgery performed within 3 years of the primary procedure. All but five of the pitchers who underwent revision UCL reconstruction had more than 2 years of follow-up available. Of those, 17 pitchers (65%) pitched a minimum of one major league game after revision and 11 (42%) pitched 10 or more major league games.
Following revision UCL reconstruction, pitchers had a shorter average career expectancy (2.64 seasons) than age- and position-matched controls (4.92 seasons). Average length of recovery for pitchers who returned to the major league level was 20.76 months. Durability was lower (50% fewer innings and total pitches logged per season) following revision UCL reconstruction in 88% of pitchers who returned to the major league level. The earned run average, batting average against and fastball velocity also were worse than controls in this cohort.
“Unfortunately, we do not have any intraoperative or clinical data to help identify factors that led to these early fatal factors,” Joseph Liu, MD, said in his presentation, “But, some of our coauthors have speculated that potentially, this may be previously due to returning pitchers too early, such as being too aggressive with rehabilitation, or there being some economic factors at play, such as players preferring to undergo revision surgery if their performance is not up to par.”— by Christian Ingram
Reference:
Liu J, et al. Paper #317. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 1-5, 2016; Orlando, Fla.
Disclosure: Liu reports no relevant financial disclosures.