Epidemiology of ulnar collateral ligament reconstruction in Major and Minor League Baseball pitchers: comprehensive report of 1429 cases

Camp, Christopher L.; Conte, Stan; D’Angelo, John; Fealy, Stephen

doi:10.1016/j.jse.2018.01.024

Cited by 121 publications

(128 citation statements)

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“…‡ While the results of MUCL reconstruction are generally reliable in throwing athletes, the vast majority of this literature is still focused on the young, elite athlete population utilizing autograft. 9 …”

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confidence: 99%

Is Allograft Reconstruction of the Medial Ulnar Collateral Ligament of the Elbow a Viable Option for Nonelite Athletes? Outcomes at a Mean of 8 Years

Kennon

Marigi

Songy

et al. 2020

Orthopaedic Journal of Sports Medicine

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Background: The rate of elbow medial ulnar collateral ligament (MUCL) injury and surgery continues to rise steadily. While authors have failed to reach a consensus on the optimal graft or anchor configuration for MUCL reconstruction, the vast majority of the literature is focused on the young, elite athlete population utilizing autograft. These studies may not be as applicable for the “weekend warrior” type of patient or for young kids playing on high school leagues or recreationally without the intent or aspiration to participate at an elite level. Purpose: To investigate the clinical outcomes and complication rates of MUCL reconstruction utilizing only allograft sources in nonelite athletes. Study Design: Case series; Level of evidence, 4. Methods: Patient records were retrospectively analyzed for individuals who underwent allograft MUCL reconstruction at a single institution between 2000 and 2016. A total of 25 patients met inclusion criteria as laborers or nonelite (not collegiate or professional) athletes with a minimum of 2 years of postoperative follow-up. A review of the medical records for the included patients was performed to determine survivorship free of reoperation, complications, and clinical outcomes with use of the Summary Outcome Determination (SOD) and Timmerman-Andrews scores. Statistical analysis included a Wilcoxon rank-sum test to compare continuous variables between groups with an alpha level set at .05 for significance. Subgroup analysis included comparing outcome scores based on the allograft type used. Results: Twenty-five patients met all inclusion and exclusion criteria. The mean time to follow-up was 91 months (range, 25-195 months), and the mean age at the time of surgery was 25 years (range, 12-65 years). There were no revision operations for recurrent instability. The mean SOD score was 9 (range, 5-10) at the most recent follow-up, and the Timmerman-Andrews scores averaged 97 (range, 80-100). Three patients underwent subsequent surgical procedures for ulnar neuropathy (n = 2) and contracture (n = 1), and 1 patient underwent surgical intervention for combined ulnar neuropathy and contracture. Conclusion: Allograft MUCL reconstruction in nonelite athletes demonstrates comparable functional scores with many previously reported autograft outcomes in elite athletes. These results may be informative for elbow surgeons who wish to avoid autograft morbidity in common laborers and nonelite athletes with MUCL incompetency.

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confidence: 99%

Is Allograft Reconstruction of the Medial Ulnar Collateral Ligament of the Elbow a Viable Option for Nonelite Athletes? Outcomes at a Mean of 8 Years

Kennon

Marigi

Songy

et al. 2020

Orthopaedic Journal of Sports Medicine

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“…Many articles on MCL reconstructions (in overhead-athletic populations) have been published. 60 The (modified) Docking technique appears to be superior over Jobe’s figure-of-eight technique. 61 Case series on LCL or MCL reconstructions following RHA have not been published.…”

Section: Diagnosis and Treatmentmentioning

confidence: 99%

Management of the failed radial head arthroplasty

et al. 2020

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Primary radial head arthroplasty (RHA) produces good or excellent results in approximately 85% of patients. However, complications are not uncommon and have been described in up to 23% of cases. The number of RHA is increasing, and consequently the absolute number of complications is expected to rise as well. The decision on whether to revise or remove the prosthesis seems more likely to depend on the preference of the surgeon or the hospital, rather than on objectifying problems with the prosthesis. The current article presents an algorithm for the work-up and treatment of most complications that can occur following RHA. Five subgroups of problems were identified: osteoarthritis, stiffness, instability, infection and implant-related issues. In short, the preferred treatment depends mainly on the chondral condition and stability of the elbow joint. Cite this article: EFORT Open Rev 2020;5:398-407. DOI: 10.1302/2058-5241.5.190055

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“…The epidemiology of UCL injury is well described in the throwing athlete [3,5,[10][11][12]. Studies specifically evaluating non-throwing athletes are comparatively sparse.…”

Section: Epidemiology Of Elbow Injuries In Non-throwing Sportsmentioning

confidence: 99%

“…His return to MLB pitching in 1976 and the subsequent case series of 16 reconstructions produced by Jobe in 1986 [1] transformed the treatment and prognosis for athletes with what was previously considered a career ending injury. Since that time, an abundance of UCL literature has been produced, characterizing injury mechanism [2] and epidemiology [3][4][5], various modifications of surgical technique [6], and outcomes of surgery with return to play metrics at various levels from high school to professional sports [7][8][9]. The overwhelming majority of these studies, however, were performed in the overhead throwing athlete-specifically baseball pitchers.…”

Section: Introductionmentioning

confidence: 99%

UCL Injury in the Non-throwing Athlete

Ramos

Limpisvasti

2019

Curr Rev Musculoskelet Med

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Purpose of Review Primarily reported in the overhead throwing athlete, ulnar collateral ligament (UCL) injuries have been extensively studied since Dr. Frank Jobe first described his technique for ulnar collateral ligament reconstruction on professional baseball pitcher Tommy John. While the framework for our understanding of UCL injury was initially established studying the repetitive valgus loading of the throwers' elbow, other sport-related activities in non-throwing athletes can impart similar valgus stress on the medial elbow placing the UCL at risk for injury. The purpose of this review is to evaluate the current literature on UCL injury specifically in the non-throwing athlete. Recent Findings In the four decades since Dr. Jobe's seminal description of UCL reconstruction, an abundance of literature has been published on UCL injury in the throwing athlete. The evidence evaluating the UCL specifically in the non-throwing athlete, however, is quite scarce. Several small retrospective studies have demonstrated good results with high rates of return to play with focused rehabilitation and non-operative management in non-throwing athletes. Recent evidence has also demonstrated that surgical repair and/or reconstruction of the UCL in this population can produce good outcomes. Summary The level of evidence of these published studies is low and consists primarily of case series without control groups. Further investigation is warranted to determine the optimal treatment algorithm for UCL injury in the non-throwing athlete. Keywords Ulnar collateral ligament injury. Non-throwing athlete. Non-operative treatment. Ulnar collateral ligament repair. Ulnar collateral ligament reconstruction This article is part of the Topical Collection on Injuries in Overhead Athletes

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Epidemiology of ulnar collateral ligament reconstruction in Major and Minor League Baseball pitchers: comprehensive report of 1429 cases

Cited by 121 publications

References 21 publications

Is Allograft Reconstruction of the Medial Ulnar Collateral Ligament of the Elbow a Viable Option for Nonelite Athletes? Outcomes at a Mean of 8 Years

Is Allograft Reconstruction of the Medial Ulnar Collateral Ligament of the Elbow a Viable Option for Nonelite Athletes? Outcomes at a Mean of 8 Years

Management of the failed radial head arthroplasty

UCL Injury in the Non-throwing Athlete

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