Long-term Outcomes After Ulnar Collateral Ligament Reconstruction in Competitive Baseball Players: Minimum 10-Year Follow-up.
BACKGROUND
Ulnar collateral ligament reconstruction (UCLR) has afforded baseball players with excellent results; however, previous studies have described only short-term outcomes.


OBJECTIVE
To evaluate long-term outcomes after UCLR in baseball players.


METHODS
Case series; Level of evidence, 4.


METHODS
All UCLRs performed on competitive baseball players with a minimum 10-year follow-up were identified. Surgical data were collected prospectively and patients were surveyed by telephone follow-up, during which scoring systems were used to assess baseball career and post-baseball career outcomes.


RESULTS
Of 313 patients, 256 (82%) were contacted at an average of 12.6 years; 83% of these baseball players (90% pitchers) were able to return to the same or higher level of competition in less than 1 year, but results varied according to preoperative level of play. Baseball career longevity was 3.6 years in general and 2.9 years at the same or higher level of play, but major and minor league players returned for longer than did collegiate and high school players after surgery (P < .001). Baseball retirement typically occurred for reasons other than elbow problems (86%). Many players had shoulder problems (34%) or surgery (25%) during their baseball career, and these occurrences most often resulted in retirement attributable to shoulder problems (P < .001). For post-baseball career outcomes, 92% of patients were able to throw without pain, and 98% were still able to participate in throwing at least on a recreational level. The 10-year minimum follow-up scores (mean ± standard deviation) for the Disabilities of the Arm, Shoulder and Hand (DASH), DASH work module, and DASH sports module were 0.80 ± 4.43, 1.10 ± 6.90, and 2.88 ± 11.91, respectively. Overall, 93% of patients were satisfied, with few reports of persistent elbow pain (3%) or limitation of function (5%).


CONCLUSIONS
Long-term follow-up of UCLRs in baseball players indicates that most patients were satisfied, with few reports of persistent elbow pain or limitation of function. During their baseball career, most of these athletes were able to return to the same or higher level of competition in less than 1 year, with acceptable career longevity and retirement typically for reasons other than the elbow. According to a standardized disability and outcome scale, patients also had excellent results after UCLR during daily, work, and sporting activities.
Orlando Health Orthopedic Institute, Orlando, Florida, USA osbahrd@gmail.com.
Daryl C
DC
Osbahr
American Sports Medicine Institute, Birmingham, Alabama, USA.
E Lyle
EL
Cain
University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA.
B Todd
BT
Raines
American Sports Medicine Institute, Birmingham, Alabama, USA.
Dave
D
Fortenbaugh
American Sports Medicine Institute, Birmingham, Alabama, USA.
Jeffrey R
JR
Dugas
American Sports Medicine Institute, Birmingham, Alabama, USA.
James R
JR
Andrews
D000328:Adult; D054874:Athletic Performance; D001484:Baseball / Q000293:injuries*; D017885:Collateral Ligaments / Q000293:injuries / Q000601:surgery*; D004185:Disability Evaluation; D004551:Elbow Joint / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D012179:Retirement / Q000706:statistics & numerical data; D000068958:Return to Sport
Tommy John surgery; baseball; elbow; ulnar collateral ligament insufficiency; ulnar collateral ligament reconstruction