背景:头顶运动员特别容易患肘部外翻超负荷综合征和肘部后内侧病理变化的发展。尽管经常进行关节镜清理/骨赘切除术,很少有研究分析了这个过程的结果,没有人专门针对专业水平的运动员。
目标:我们假设在肘关节后内侧清创术后,美国职业棒球大联盟(MLB)投手的尺侧副韧带(UCL)重建率高于现有文献中的基线发生率,随着投球性能的下降。
方法:使用可公开访问的网站,确定了从2007年至2022年接受后内侧肘部清创的MLB运动员。人口统计信息,程序详细信息,返回播放(RTP)信息,返回到残疾/受伤名单(DL/IL),随后的UCL重建,和俯仰统计进行了分析。投球性能指标包括平均盈利跑分(ERA),每局的步行加命中(WHIP),一局投球,和快球速度。
结果:总共39名MLB球员,包括26个投手,包括在内。在手术后的前三个季节里,82.1%(n=32)的球员以平均176.1±69天的时间返回MLB级别。投手在175.8±16天表现出76.9%(n=20)的重返比赛(RTP)率。在三个季节内,共有38.5%(n=10)的投手因肘部相关问题返回DL/IL。随后的UCL重建只在投手中看到,频率为19.2%(n=5)。单赛季前/术后投球指标之间没有统计学上的显着差异。在三个季节的比较中,观察到快球速度的小幅但显着(p<0.05)下降(94.4vs92.84;p=0.02)。
结论:与我们的假设相反,这项研究表明,后内侧肘部清创术是MLB运动员的可行手术,RTP率为82.1%,UCL重建率无增加。此外,单赛季术前和术后统计投球表现无显著差异。然而,术后三年多,对于正在进行的肘部疾病,DL/IL的回报率为38.5%,俯仰速度显着下降,引起了人们对术后改善寿命的担忧。
BACKGROUND: Overhead athletes are particularly susceptible to elbow valgus extension overload syndrome and development of pathologic changes in the posteromedial elbow. Though arthroscopic débridement/
osteophyte resection is frequently performed, few studies have analyzed the outcomes of this procedure, and none have specifically addressed professional level athletes.
OBJECTIVE: We hypothesized that following posteromedial elbow débridement, Major League Baseball (MLB) pitchers would exhibit a higher rate of ulnar collateral ligament (UCL) reconstruction than baseline incidence in the existing literature, along with a decline in pitching performance.
METHODS: Using publicly accessible websites, MLB athletes undergoing posteromedial elbow débridement from 2007 to 2022 were identified. Demographic information, procedure details, return to play (RTP) information, return to the disabled/injured list (DL/IL), subsequent UCL reconstruction, and pitching statistics were analyzed. Pitching performance metrics included Earned Runs Average (ERA), Walks Plus Hits Per Innings Pitched (WHIP), innings pitched, and fastball velocity.
RESULTS: A total of 39 MLB players, including 26 pitchers, were included. Within the first three seasons after surgery, 82.1% (n=32) of players returned to play at the MLB level at a mean time of 176.1 ± 69 days. Pitchers exhibited a return to play (RTP) rate of 76.9% (n=20) at 175.8 ± 16 days. A total of 38.5% (n=10) of pitchers returned to the DL/IL for elbow-related issues within three seasons. Subsequent UCL reconstruction was seen only in pitchers, with a frequency of 19.2% (n=5). No statistically significant differences between single season pre/postoperative pitching metrics were identified. A small but significant (p<0.05) decrease in fastball velocity (94.4 vs 92.84; p=0.02) was observed over a three-season comparison.
CONCLUSIONS: Contrary to our hypothesis, this study demonstrates that posteromedial elbow débridement is a viable surgery in MLB athletes, with RTP rate of 82.1% and no increase in rate of UCL reconstruction. Furthermore, there was no significant difference in single season pre- and postoperative statistical pitching performance. However, over three years postoperatively, there was a 38.5% rate of return to the DL/IL for ongoing elbow ailment and a significant decrease in pitch velocity, raising some concern over the longevity of postoperative improvements.