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MLB players likely to return to usual play after thumb UCL repair
Player performance was also not significantly different after surgery on the dominant vs. nondominant hand.
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Major League Baseball players who underwent repairs of full thickness thumb ulnar collateral ligament tears all achieved return to play status and the mean return to play was 8 weeks among in-season players, according to study results.
Although many injuries in baseball are due to overuse of the shoulder and elbow, investigator Patrick C. McCulloch, MD, noted collisions that occur when a player dives for a ball or slides into second base or into home can lead to acute traumatic injuries, such as an ulnar collateral ligament (UCL) tear.
“It is felt the best treatment for complete tears is acute surgical repair to maintain normal hand function,” McCulloch, an orthopedic sports medicine specialist and associate professor of clinical orthopedic surgery at Houston Methodist Hospital, told Orthopedics Today. “In professional baseball players, where their hand function is so important, our question was whether this injury is potentially career altering, and the data clearly suggest that it is not.”
Return to sport rate
Among 21 Major League Baseball (MLB) players who underwent thumb UCL surgery from August 1987 to September 2016, McCulloch and his colleagues found 100% achieved return to play status, which was defined as playing at least one MLB game after surgery. Results showed no significant decrease in games per season or career length for any position following surgery. Compared with preoperative wins, researchers found a significantly lower rate of postoperative wins among replacement among infielders. When compared with matched controls after the index date, however, researchers found no significant differences in postoperative performance score.
McCulloch said the study finding that performance was not significantly different between players who underwent surgery on their dominant hand and players who underwent surgery on their nondominant hand was surprising.
“I assumed their return to play might be based on whether it was their glove hand or throwing hand, but that did not seem to matter in our results. If it happened during the season and there was enough season left, they got back on an average of 8 weeks regardless,” he said.
Study time from injury to surgery
Since the study was based on publicly available data and not from a physical examination of the researchers, McCulloch said they were unable to include some information, such as the type of repair or time from initial injury to surgery. Future research should include information on time from injury to surgery, he said.
“It would be interesting to know whether some players may be successful wearing a brace if it was on their glove hand and to potentially wait until the end of the season to have a surgery. However, some of those players could potentially need a reconstruction rather than a repair, so that still remains to be known,” McCulloch said. “For now, the gold standard is acute repair for a full-thickness tear of the UCL in baseball players. This study allows the player, agent and fans know the player is playing at a similar level in about 2 months,” – by Casey Tingle
- Reference:
- Jack II RA, et al. Orthop J Sports Med. 2018;doi:10.1177/2325967117747268.
- For more information:
- Patrick C. McCulloch, MD, can be reached at 6445 Main St., Suite 2500, Houston, TX 77030; email: ddelgado@houstonmethodist.org.
Disclosure: McCulloch reports no relevant financial disclosures.