The location of an ulnar collateral ligament (UCL) tear may affect the return to sports rate of baseball players after reconstruction surgery, according to a new study.
UCL Tear Location May Affect Baseball Return to Sport
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In the study, “Ulnar Collateral Ligament Tear Location May Affect Return-to-Sports Rate but Not Performance Upon Return to Sports After Ulnar Collateral Ligament Reconstruction Surgery in Professional Baseball Players,” published in the September issue of The American Journal of Sports Medicine, researchers compared return to sport rate and performance upon return to sport differences based on the location of the UCL tear.
Data was collected on 30 professional baseball players who underwent primary ulnar ligament reconstruction (UCLR) all by the same surgeon between 2016 and 2018.
Twenty-five pitchers were included in the study. Fifteen of them had a proximal tear while the other 10 had distal tears. Overall, 84% of the pitchers were able to return to playing baseball. Five position players were also included in the study. Two of them had proximal tears and three had distal tears. Out of the 5 position players, 80% returned to the game.
Overall, 71% of the players with proximal tears were able to return to sport compared to the 100% return to sports among players with distal tears. Players with distal tears tended to have higher utilization when back on the mound, allowing for more hits (p = .03), runs (p = .015), and walks (p = .021). The WHIP ([walks + hits]/innings pitched)] however was not different between the two groups.
The researchers said this suggests that performance in games upon return to sport isn’t affected by where the tear was located.
They concluded, “Professional baseball players who sustain a distal UCL tear and undergo UCLR may be more likely to return to sport than those who sustain a proximal UCL tear and undergo UCLR. Players with distal UCL tears who underwent UCLR saw higher utilization postoperatively than those with proximal UCL tears.”
They added that further work is needed to confirm their findings.
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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