Ulnar collateral ligament repair in professional baseball players

While initial reports of surgical repair of ulnar collateral ligament tears are promising, studies detailing post-repair outcomes are lacking. This study explores the effectiveness of ulnar collateral ligament (UCL) repair in returning professional baseball players to their pre-injury level of play. Our hypothesis is that professional baseball players undergoing UCL repair will have successful outcomes and high return to sport rates after surgery.

Publicly available databases were utilized to search for data on professional baseball players who underwent UCL repair from 2016 to 2021. Players undergoing primary UCL repair with an internal brace were included. Amateur players were excluded as were those undergoing revision UCL repair or UCL reconstruction.

Of the 11 pitchers who underwent UCL repair, minor league baseball (MiLB) pitchers returned to the sport at an average of 17.5 months. MiLB pitchers had similar earned run averages (ERAs), games played, innings pitched, and walks plus hits per inning pitched ratios (WHIPs) before and after surgery. Four major league baseball (MLB) pitchers (80%) returned to the sport at 9.55 months. MLB pitchers played fewer games and pitched fewer innings than before the surgery, but their ERAs and WHIPs were similar before and after surgery. Pitch velocity and spin rates after surgery varied based on pitch type. The seven positional players who underwent UCL repair showed no differences in batting or fielding performance before and after surgery.

UCL repair can successfully return both pitchers and positional players at both the MiLB and MLB levels to play at pre-injury performance levels. Repair can be considered as an option for qualifying injuries in players hoping to maximize performance after surgery with minimal recovery time. Level of Evidence: IV.