Performance in Collegiate-Level Baseball Players After Elbow Ulnar Collateral Ligament Reconstruction

The increase in ulnar collateral ligament (UCL) elbow reconstructions over the past 20 years has affected younger athletes more than any other age group. Although return to play and postoperative performance have been extensively studied in professional baseball players, outcomes in collegiate baseball players are less known.

The purpose of this study was to characterize return to play and changes in performance after UCL reconstruction (UCLR) in collegiate baseball players. We hypothesized that collegiate baseball players would have similar return-to-play rates compared with professional athletes and no significant differences in performance compared with matched controls.

Cohort study; Level of evidence, 3.

Collegiate athletes undergoing UCLR by a single surgeon were identified. Postoperatively, individual collegiate career paths were analyzed through use of publicly available data from team websites, injury reports, and press releases. Data obtained included time to return to competition, number of collegiate seasons played after surgery, total games started and played, seasonal wins, losses, saves, innings played, hits, earned run average (ERA), home runs, shutouts, strikeouts, walks, and walks plus hit per inning pitched (WHIP). The UCLR group was compared with a matched control group of collegiate pitchers without elbow injury.

Of the 58 collegiate baseball players analyzed (mean ± SD age, 19.95 ± 1.19 years), 84.5% returned to play at the collegiate level. Players returned to competition at 16.98 ± 6.16 months postoperatively and competed for 1.60 ± 0.84 seasons postoperatively. In terms of career longevity, 81.0% of collegiate pitchers either completed their collegiate eligibility or remained on active rosters, and 2 players (4.1%) ultimately played at the professional level after UCLR. Compared with a matched cohort, the UCLR group had no significant differences in collegiate pitching performance statistics after surgery.

College baseball players returned to play at a rate comparable with the rate published in prior literature on professional pitchers and often completed their collegiate playing eligibility postoperatively. Compared with controls, the UCLR group had no statistically significant differences in pitching performance postoperatively. Further studies are needed to determine the exact reasons why college players retire despite having endured extensive surgical and postoperative rehabilitation processes related to UCLR. Younger populations are experiencing elbow injuries at an increasing rate secondary to increased workloads at the amateur level. As these athletes matriculate into the collegiate ranks, they are at continued risk of sustaining UCL injury, and little explicit information is available on their prospects of return to play and career longevity after UCLR.