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Revision Ulnar Collateral Ligament Reconstruction in Major League Baseball Pitchers: Effects of Fastball Velocity and Usage. Journal of shoulder and elbow surgery LaPrade, C. M., Cinque, M. E., Chona, D. V., Sciascia, A. D., Abrams, G. D., Sherman, S. L., Safran, M. R., Freehill, M. T. 2022


Ulnar collateral ligament (UCL) tears are prevalent in Major League Baseball (MLB) pitchers and can cause significant loss of time with varying reports of impact on performance. Revision UCL reconstruction (UCLR) is becoming increasingly common, with little known about the effects on fastball velocity (FB) and usage (FB%) in this setting.The purpose was to evaluate the effect of revision UCLR on MLB pitchers with respect to post-operative FB velocity and FB% usage at one and two years after return-to-play. The hypothesis was post-operative FB velocity and FB% usage would significantly decrease versus pre-revision levels, and that revision UCLRs would result in significantly decreased FB velocity and FB% usage in comparison to a matched group of MLB pitchers after primary UCLR.Twenty-one pitchers who underwent revision UCLR and returned to MLB play were identified from public records from 2008-2021. The PITCHf(x) system collected FB velocity for four-seam (4FB) and two-seam (2FB) fastballs and total FB% for pitchers in the pre-revision year as well as the two years after return. A matched control group of pitchers who underwent primary UCLR was used for comparison.There were no significant differences in FB velocity between pre-revision levels (4FB 92.9 mph, 2FB 91.4 mph) and years one (4FB 92.5 mph) (2FB 91.2 mph) and two (4FB 93.4 mph) (2FB 91.1 mph) after revision UCLR. FB% decreased from the pre-revision season (60.1) and the first (56.2, p=0.036) and second years (52.5, p=0.002) after return. There were no significant differences between FB velocity or FB% or between the revision and primary UCLR groups.Pitchers returning to the MLB level after revision UCLR can expect similar FB velocity pre-revision FB velocity and to pitchers undergoing primary UCLR; however, they do demonstrate a decrease in FB% usage, which may suggest less confidence in their FB after RTP.

View details for DOI 10.1016/j.jse.2022.02.026

View details for PubMedID 35351655