Return-to-Play Rates and Clinical Outcomes of Baseball Players After Concomitant Ulnar Collateral Ligament Reconstruction and Selective Ulnar Nerve Transposition.

Authors

Somnath Rao, Rothman Institute; Thomas Jefferson UniversityFollow
Taylor D'Amore, Rothman Institute; Thomas Jefferson UniversityFollow
Donald P. Willier, Rothman Institute; Thomas Jefferson UniversityFollow
Richard J. Gawel, Rothman Institute; Thomas Jefferson UniversityFollow
Robert A Jack, Houston Methodist
Steven B. Cohen, Rothman Institute; Thomas Jefferson UniversityFollow
Michael G. Ciccotti, Rothman Institute; Thomas Jefferson UniversityFollow

Document Type

Article

Publication Date

11-23-2021

Comments

This article is the authors’ final published version in Orthopaedic Journal of Sports Medicine, Volume 9, Issue 11, November 2021, Article number 23259671211055428.

The published version is available at https://doi.org/10.1177/23259671211055428. Copyright © Rao et al.

Abstract

Background: Injury to the ulnar collateral ligament (UCL) leading to medial elbow instability and possible ulnar neuritis is common in overhead-throwing athletes. Treatment may require UCL reconstruction (UCLR) and concomitant ulnar nerve transposition (UNT) for those with preoperative ulnar neuritis.

Purpose: To evaluate the return-to-play (RTP) rates, clinical outcomes, and rates of persistent ulnar neuritis after concomitant UCLR and UNT in a cohort of baseball players with confirmed preoperative ulnar neuritis.

Study Design: Case series; Level of evidence, 4.

Methods: Eligible patients were those who underwent concomitant UCLR and UNT at a single institution between January 2008 and June 2018 and who had a minimum of 2 years of follow-up. Additional inclusion criteria were athletes who identified as baseball players and who had a confirmed history of ulnar neuritis. Patients were contacted at a minimum of 2 years from surgery and assessed with the Kerlan-Jobe Orthopaedic Clinic (KJOC) Shoulder and Elbow Score, Andrew-Timmerman (A-T) Elbow Score, Mayo Elbow Performance Score (MEPS), Single Assessment Numeric Evaluation (SANE) score, and a custom RTP questionnaire.

Results: Included were 22 male baseball players with a mean age of 18.9 ± 2.1 years (range, 16-25 years). The mean follow-up was 6.1 ± 2.4 years (range, 2.5-11.7 years). Preoperatively, all 22 patients reported ulnar nerve sensory symptoms, while 4 (18.2%) patients reported ulnar nerve motor symptoms. At the final follow-up, 7 (31.8%) patients reported persistent ulnar nerve sensory symptoms, while none of the patients reported persistent ulnar nerve motor symptoms. Overall, 16 (72.7%) players were able to return to competitive play at an average of 11.2 months. The mean postoperative patient-reported outcome scores for the KJOC Shoulder and Elbow Score, MEPS, A-T Elbow Score, and SANE score were 77.9 ± 20.9 (range, 14-100), 92.7 ± 12.7 (range, 45-100), 86.1 ± 17.1 (range, 30-100), and 85.5 ± 14.8 (range, 50-100), respectively.

Conclusion: This study demonstrated that after concomitant UCLR and UNT for UCL insufficiency and associated ulnar neuritis, baseball players can expect reasonably high RTP rates and subjective outcomes; however, rates of persistent sensory ulnar neuritis can be as high as 30%.

Recommended Citation

Rao, Somnath; D'Amore, Taylor; Willier, Donald P.; Gawel, Richard J.; Jack, Robert A; Cohen, Steven B.; and Ciccotti, Michael G., "Return-to-Play Rates and Clinical Outcomes of Baseball Players After Concomitant Ulnar Collateral Ligament Reconstruction and Selective Ulnar Nerve Transposition." (2021). Rothman Institute Faculty Papers. Paper 153.
https://jdc.jefferson.edu/rothman_institute/153

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This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Language

English