title: Should We Limit Innings Pitched After Ulnar Collateral Ligament Reconstruction in Major League Baseball Pitchers?
abstract: Ulnar collateral ligament reconstruction (UCLR) has become a common procedure among Major League Baseball (MLB) pitchers. It is unclear if a limit on innings pitched after UCLR should be instituted to prevent revision UCLR.
  
  
  
  Number of innings pitched and number of pitches thrown after UCLR will not affect whether a pitcher requires a revision UCLR.
  
  
  
  Descriptive laboratory study.
  
  
  
  All MLB pitchers between 1974 and 2015 who pitched at least 1 full season after UCLR were included in this study. Pitch counts and innings pitched for the first full season after UCLR as well as total pitch count and total innings pitched were recorded. Pitch counts and innings pitched were compared among players who required revision UCLR and those who did not.
  
  
  
  Overall, 154 pitchers were included. Of these, 135 pitchers did not require revision UCLR while 19 underwent revision UCLR. No significant difference existed between pitchers who underwent revision UCLR and those who did not when comparing number of innings pitched in the season after UCLR (79.4 ± 46.7 vs 90.1 ± 58.6; P = .9016), number of pitches thrown in the season after UCLR (1233.2 ± 710.4 vs 1449.2 ± 904.1; P = .7337), number of innings pitched in the pitcher's career after UCLR (357.4 ± 312.0 vs 399.3 ± 446.4; P = .6945), and number of pitches thrown in the pitcher's career after UCLR (5632.7 ± 4583.9 vs 5674.7 ± 5755.4; P = .4789), respectively. Furthermore, no difference existed in revision rate between pitchers who pitched more or less than 180 innings in the first full season after UCLR (P = .6678).
  
  
  
  The number of innings pitched and number of pitches thrown in the first full season as well as over a player's career after UCLR are not associated with an increased risk of a pitcher requiring revision UCLR.
authors.affiliation: Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, IL, USA berickso.24@gmail.com.
authors.forename: Brandon J
authors.initials: BJ
authors.lastname: Erickson
authors.affiliation: Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Gregory L
authors.initials: GL
authors.lastname: Cvetanovich
authors.affiliation: Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Bernard R
authors.initials: BR
authors.lastname: Bach
authors.affiliation: Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Charles A
authors.initials: CA
authors.lastname: Bush-Joseph
authors.affiliation: Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Nikhil N
authors.initials: NN
authors.lastname: Verma
authors.affiliation: Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Anthony A
authors.initials: AA
authors.lastname: Romeo
mesh_terms: D001484:Baseball; D000070637:Collateral Ligament, Ulnar / Q000601:surgery*; D004551:Elbow Joint / Q000601:surgery; D006801:Humans; D008297:Male; D000070638:Ulnar Collateral Ligament Reconstruction / Q000379:methods*
keywords: Major League Baseball (MLB); Tommy John; outcome; pitcher; revision; ulnar collateral ligament reconstruction (UCLR)