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. 2018 Jun;27(6):1078-1085.
doi: 10.1016/j.jse.2018.01.023. Epub 2018 Mar 23.

Following ulnar collateral ligament reconstruction, professional baseball position players return to play faster than pitchers, but catchers return less frequently

Christopher L Camp  1 , Stan Conte  2 , John D'Angelo  3 , Stephen A Fealy  4
Affiliations

Following ulnar collateral ligament reconstruction, professional baseball position players return to play faster than pitchers, but catchers return less frequently

Christopher L Camp et al. J Shoulder Elbow Surg. 2018 Jun.

Abstract

Background: Although much as been done to characterize trends of medial ulnar collateral ligament (UCL) reconstruction in pitchers, outcomes in position players (PPs) (non-pitchers) remain undefined in the current literature.

Methods: Three resources were combined to identify all known Major League Baseball and Minor League Baseball (MiLB) PPs who have ever undergone UCL reconstruction. A multitude of player and surgical variables were included. Trends over time were analyzed collectively, based on level of play, revision status (primary vs revision), and position. Additional comparisons were made with a known cohort of professional baseball pitchers having undergone UCL reconstruction.

Results: We identified 168 UCL reconstructions in professional PPs. The annual rate of primary UCL reconstruction rose significantly from 1984 to 2015 (P < .001), and the proportion of cases performed in MiLB PPs (vs Major League Baseball PPs) increased steadily (P < .001). Of PPs, 75.5% returned to play at any level at a mean of 342 days. Catchers demonstrated the lowest return-to-play (RTP) rate (58.6%) compared with infielders (75.6%) and outfielders (88.9%). The overall revision rate was low, at 4.8%. Compared with pitchers, PPs demonstrated a lower rate of RTP (75.5% for PPs vs 83.7% for pitchers, P = .040) but shorter RTP times for those able to return (342 days for PPs vs 435 days for pitchers, P < .001).

Conclusions: The incidence of UCL reconstruction in PPs continues to rise, a trend that is significantly more pronounced at the MiLB level. Although PPs (particularly catchers) are less likely to return to professional baseball compared with pitchers, those who are able to RTP do so more rapidly.

Keywords: Major League Baseball; Medial ulnar collateral ligament reconstruction; Minor League Baseball; Tommy John; position players; professional baseball.

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