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Lu Y, Chen P, Sheu H, Yang CP, Cheng YH, Chen ACY, Chiu JCH. Fastball Quality After Ulnar Collateral Ligament Reconstruction in Major League Baseball Pitchers. Am J Sports Med 2024; 52:2611-2619. [PMID: 39126190 DOI: 10.1177/03635465241262339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/12/2024]
Abstract
BACKGROUND The ulnar collateral ligament (UCL) is essential for elbow stability during pitching. In professional baseball, the fastball (FB) is the most commonly used pitch, making postrecovery FB performance after UCL reconstruction (UCLR) a crucial aspect to consider. HYPOTHESES (1) Pitchers undergoing UCLR would show no significant changes in performance metrics compared with nonoperated pitchers with similar FB velocity and spin rate, and (2) no significant variance would be found in these metrics within the operated pitchers concerning their preinjury anthropometric characteristics and pitching performance metrics. STUDY DESIGN Cohort study; Level of evidence, 3. METHODS The study included 91 Major League Baseball (MLB) pitchers who underwent primary UCLR between January 1, 2015, and December 31, 2021. A matched 1:1 control group of MLB pitchers without UCLR injuries was established. Publicly available pitch metrics and anthropometric data were compared between the study and control groups. RESULTS Disparities in several performance metrics emerged during the first postreturn year (PRY1), including FB use percentage (P = .029), fielder independent pitching (FIP) (P = .021), and standardized FB runs above average per 100 pitches (wFB/C) (P < .001). Subgroup analysis within the UCLR group revealed a negative correlation between presurgery mean FB velocity and its subsequent change (P < .001) and a positive correlation with changes in FIP (P = .025) from the index year to PRY1. A negative correlation was observed between FB use percentage in the index year and its change by PRY1 (P = .002). By the second postreturn year, no significant differences were found in these performance metrics. No factors were significantly related to prolonged recovery time. CONCLUSION Although FB velocity and spin rate remained consistent, significant differences were observed in FB use percentage, FIP, and wFB/C in PRY1. However, by second postreturn year, these differences were no longer significant. No specific risk factors were identified concerning prolonged recovery time between pre-UCLR FB pitching metrics and the physical anthropometric data. These results suggest that although the short-term postsurgery period may affect more specialized pitching metrics, the basic pitching performance metrics, as hypothesized, remain largely unaffected by UCLR.
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Affiliation(s)
- Yi Lu
- Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Bone and Joint Research Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Comprehensive Sports Medicine Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Poyu Chen
- Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Huan Sheu
- Bone and Joint Research Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Comprehensive Sports Medicine Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Orthopedic Surgery, Taoyuan Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Cheng-Pang Yang
- Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Bone and Joint Research Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Comprehensive Sports Medicine Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - You-Hung Cheng
- Department of Orthopedic Surgery, New Taipei Municipal Tucheng Hospital, New Taipei City, Taiwan
| | - Alvin Chao-Yu Chen
- Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Bone and Joint Research Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Comprehensive Sports Medicine Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Joe Chih-Hao Chiu
- Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Bone and Joint Research Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Comprehensive Sports Medicine Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Chang Gung University College of Medicine, Taoyuan, Taiwan
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Zaremski JL, Bowers RL, Kriz PK. Pitching Restriction Policies in Adolescent and High-School Baseball Pitchers: Is It Time for an Updated Paradigm? Clin J Sport Med 2024; 34:1-9. [PMID: 37678800 DOI: 10.1097/jsm.0000000000001188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 08/09/2023] [Indexed: 09/09/2023]
Affiliation(s)
- Jason L Zaremski
- Division of Sports Medicine, Department of Physical Medicine and Rehabilitation, University of Florida, Gainesville, Florida
| | - Robert L Bowers
- Division of Sports Medicine, Department of Orthopaedics, Emory University School of Medicine, Atlanta, Georgia
- Department of Physical Medicine and Rehabilitation, Emory University School of Medicine, Atlanta, Georgia; and
| | - Peter K Kriz
- Division of Sports Medicine, Departments of Orthopaedics and Pediatrics, Brown University, Providence, Rhode Island
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Kriz JP, DeFroda S, Staffa SJ, Kriz PK. Effect of High School Showcase Exposures and Timing of Ulnar Collateral Ligament Tear on Professional Baseball Careers in Elite Pitchers. Am J Sports Med 2023; 51:926-934. [PMID: 36779588 DOI: 10.1177/03635465221150509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
BACKGROUND Showcase participation has been considered a risk factor for elbow injuries. It remains unclear whether high school (HS) showcase volume negatively affects pitchers' career paths. Because pitchers are achieving 90 mph thresholds at younger ages, it is unknown whether shorter time intervals between achieving 90 mph thresholds and dates of ulnar collateral ligament reconstruction (UCL-R), known as time to tear (TTT), may affect career trajectory. HYPOTHESIS Elite pitchers with higher HS showcase volumes would be less likely to reach Major League Baseball (MLB) level compared with elite pitchers with fewer HS showcase appearances. Elite pitchers with longer TTT intervals would be more likely to achieve MLB level. STUDY DESIGN Cohort study; Level of evidence, 3. METHODS Demographic, HS showcase and professional performance, and injury data from pitchers selected in the first 5 rounds of the MLB draft (2011-2017) were gathered from publicly available databases. Continuous and categorical variables were compared for the following subgroups: UCL-R group and pitcher group not undergoing UCL-R; "early" and "late" UCL-R groups; and pitchers achieving and pitchers not achieving MLB level. Multivariable analysis was performed using logistic regression. Standard deviations of ±1 SD were used to define early career versus late career UCL-R subgroups after normal distribution was confirmed (Shapiro-Wilk test; P = .227). The early UCL-R group was defined as those pitchers undergoing UCL-R ≤-1 SD from the mean age at first injury (group mean age, 19.43 years), whereas the late UCL-R group was defined as ≥+1 SD from that age (group mean age, 25.19 years). RESULTS Of 611 pitchers, 455 (74.5%) had HS showcase performance data, and 608 (99.5%) had professional performance data. In total, 184 (30.1%) pitchers underwent UCL-R. Fewer pitchers who underwent early UCL-R achieved the MLB level compared with pitchers who underwent late UCL-R (48.1% vs 86.2%; P = .006). Elite pitchers who pitched in ≥10 showcases in HS had half the odds of achieving the MLB level compared with pitchers who participated in <10 HS showcases (adjusted odds ratio, 0.50; 95% CI, 0.29-0.86; P = .012). For every year longer that an elite pitcher did not tear his UCL after achieving the 90 mph threshold at an HS showcase (TTT after 90 mph [per year]), the likelihood of achieving the MLB level increased by 24% (adjusted odds ratio, 1.24; 95% CI, 1.02-1.52; P = .032). CONCLUSION Higher HS showcase volume in elite pitchers was associated with a lower likelihood of achieving MLB level. A longer TTT after 90 mph (per year) was significantly associated with achieving MLB level in elite pitchers.
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Affiliation(s)
| | - Steven DeFroda
- Division of Sports Medicine, University of Missouri, Columbia, Missouri, USA
| | - Steven J Staffa
- Department of Anesthesiology, Critical Care and Pain Medicine, Harvard Medical School, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Peter K Kriz
- Division of Sports Medicine, Departments of Orthopedics and Pediatrics, Warren Alpert Medical School, Brown University, Rhode Island Hospital/Hasbro Children's Hospital, Providence, Rhode Island, USA
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Baseball-Showcases und Verletzungen des ulnaren Kollateralbandes. SPORTVERLETZUNG · SPORTSCHADEN 2022. [DOI: 10.1055/a-1933-4711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
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