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Author Spotlight: Implementing the Enhanced Recovery After Surgery Concept in Rehabilitation Following Anterior Cruciate Ligament Reconstruction

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Association Between Preoperative Patient-Reported Questionnaires and Outcomes After Ulnar Collateral Ligament

Christopher Ahmad¹, Cole Morrissette¹, Frank Alexander¹

¹Sports Medicine Division, Orthopedic Surgery, Columbia University Medical Center, New York, New York, USA.

Orthopaedic Journal of Sports Medicine

|December 19, 2025

Summary

This summary is machine-generated.

Better preoperative patient-reported outcomes (PROs) predict faster recovery and fewer complications after ulnar collateral ligament (UCL) surgery in throwing athletes. UCL repair offers quicker return to throwing and mound than reconstruction.

Keywords:

patient-reported outcome pitching injuries return to sport throwing athletes ulnar collateral ligament

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Area of Science:

Orthopedic surgery
Sports medicine
Rehabilitation

Background:

Ulnar collateral ligament (UCL) injuries are common in throwing athletes.
Predicting recovery and complications after UCL surgery remains challenging.
The impact of preoperative patient-reported outcomes (PROs) on postoperative recovery is not well understood.

Purpose of the Study:

To determine if baseline PROs and surgical variables predict postoperative milestones and adverse outcomes after UCL surgery.
To test the hypothesis that better baseline PROs correlate with improved postoperative outcomes.

Main Methods:

A cohort study analyzed data from The Pitch Registry (2019-2023) of 146 baseball players with UCL injuries and ≥2 years follow-up.
Collected preoperative PROs (ASES, KJOC, YTS) and documented postoperative outcomes (return to throwing/RTT, return to mound/RTM), complications, and surgical variables (repair vs. reconstruction).

Main Results:

Better baseline ASES scores correlated with faster RTT and fewer complications.
Worse ASES pain scores predicted longer RTT, more complications, revision surgery, and ulnar nerve symptoms.
UCL repair showed significantly faster RTT and RTM compared to palmaris or gracilis reconstructions.

Conclusions:

Preoperative PROs, especially ASES scores, are crucial for predicting UCL surgery outcomes.
UCL repair leads to faster return to sport compared to reconstruction.
PROs can help manage patient expectations and guide surgical decision-making.