Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Sep 25;7(9):2325967119871442.
doi: 10.1177/2325967119871442. eCollection 2019 Sep.

Prevalence of Medial Ulnar Collateral Ligament Surgery in 6135 Current Professional Baseball Players: A 2018 Update

Devin P Leland  1 , Stan Conte  2 , Nancy Flynn  3 , Nicholas Conte  2 , Ken Crenshaw  4 , Kevin E Wilk  5 , Christopher L Camp  1
Affiliations

Prevalence of Medial Ulnar Collateral Ligament Surgery in 6135 Current Professional Baseball Players: A 2018 Update

Devin P Leland et al. Orthop J Sports Med. .

Abstract

Background: As the incidence of ulnar collateral ligament (UCL) surgery continues to rise rapidly, an update on the current prevalence and demographics in professional baseball players is warranted.

Hypothesis: The prevalence of UCL reconstruction in Major League Baseball (MLB) and Minor League Baseball (MiLB) players will be higher than that previously reported, and the increase in prevalence will be most notable in MiLB pitchers.

Study design: Cross-sectional study; Level of evidence, 3.

Methods: During the 2018 baseball season, an online questionnaire regarding a history of UCL surgery was distributed to the certified athletic trainers of all 30 MLB organizations. These trainers then administered the survey to all players within their organizations, including MLB, MiLB (AAA, AA, High A, Low A, High Rookie, Low Rookie), and Dominican Summer League (DSL) players. Demographics were compared between MLB, MiLB, and DSL players. Results of this 2018 survey were compared with previously published data from the 2012 season to assess the change over time.

Results: There were 6135 professional baseball players who completed the survey (66% response rate). The prevalence of UCL reconstruction in all MLB and MiLB players was 13% (637/4928), while the prevalence in DSL players was 2% (20/1207) (P < .001). The prevalence in all MLB and MiLB players (13%) and pitchers (20%) both increased significantly from 2012 (P < .001). MLB pitchers reported a higher prevalence of UCL reconstruction than did MiLB pitchers (26% vs 19%, respectively; P < .001). In 2018, the prevalence of UCL reconstruction has increased significantly in MiLB pitchers (19% vs 15%, respectively; P < .001) and pitchers aged 21 to 30 years (22% vs 17%, respectively; P < .001) compared with 2012. Additionally, United States-born pitchers were more likely to have undergone UCL reconstruction compared with Latin America-born pitchers (23% vs 13%, respectively; P < .001).

Conclusion: The prevalence of UCL reconstruction has increased significantly in professional baseball players over the past 6 years from 10% to 13%. Ultimately, the prevalence of UCL reconstruction has increased most significantly since 2012 in MiLB pitchers, pitchers aged 21 to 30 years, and pitchers born in the United States.

Keywords: Tommy John; baseball; elbow; prevalence; reconstruction; ulnar collateral ligament.

PubMed Disclaimer

Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: K.E.W. is an unpaid consultant for AlterG; has received consulting fees from LiteCure and Performance Health; has received educational support from Dynasplint; has received research support from IntelliSkin; and has received royalties from Churchill Livingstone, Mosby, and SLACK. C.L.C. has received hospitality payments from Arthrex and Zimmer Biomet. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

Figures

Figure 1.
Figure 1.
Prevalence of ulnar collateral ligament (UCL) reconstruction among pitchers in Major League Baseball (MLB), Minor League Baseball (MiLB), and MLB + MiLB combined from the 2012 and 2018 seasons. Statistically significant differences are denoted by an asterisk (*).
Figure 2.
Figure 2.
Number of ulnar collateral ligament (UCL) reconstructions among pitchers in Major League Baseball (MLB) and Minor League Baseball (MiLB) from the 2012 and 2018 seasons.
See this image and copyright information in PMC

References

    1. Cain EL, Andrews JR, Dugas JR, et al. Outcome of ulnar collateral ligament reconstruction of the elbow in 1281 athletes: results in 743 athletes with minimum 2-year follow-up. Am J Sports Med. 2010;38(12):2426–2434. - PubMed
    1. Camp CL, Conte S, D’Angelo J, Fealy SA. Epidemiology of ulnar collateral ligament reconstruction in Major and Minor League Baseball pitchers: comprehensive report of 1429 cases. J Shoulder Elbow Surg. 2018;27(5):871–878. - PubMed
    1. Camp CL, Conte S, D’Angelo J, Fealy SA. Following ulnar collateral ligament reconstruction, professional baseball position players return to play faster than pitchers, but catchers return less frequently. J Shoulder Elbow Surg. 2018;27(6):1078–1085. - PubMed
    1. Camp CL, Conte S, D’Angelo J, Fealy SA, Ahmad CS. Effect of predraft ulnar collateral ligament reconstruction on future performance in professional baseball: a matched cohort comparison. Am J Sports Med. 2018;46(6):1459–1464. - PubMed
    1. Camp CL, Dines JS, van der List JP, et al. Summative report on time out of play for Major and Minor League Baseball: an analysis of 49,955 injuries from 2011 through 2016. Am J Sports Med. 2018;46(7):1727–1732. - PubMed