Browsing by keyword "Tommy John Surgery"
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Elbow Ulnar Collateral Ligament Reconstruction Using the Novel Docking Plus Technique in 324 AthletesBACKGROUND: This retrospective case series examined 324 athletes who received elbow ulnar collateral ligament (UCL) reconstruction by a single surgeon in a private practice over a 9-year period. The novel Docking Plus technique for elbow UCL reconstruction in 324 athletes provided good or excellent Conway score results in 88% of patients. The preponderance of previous studies examining UCL reconstruction outcomes were performed by surgeons at one of only three institutions (Andrews Institute, Hospital for Special Surgery, Kerlan Jobe Orthopedic Clinic). METHODS: Patients undergoing UCL reconstruction from November 2005 to December 2014 were identified and contacted with a mailed survey and phone call. These patients were given a subjective 19 question survey assessing their outcomes from surgery. RESULTS: The participants who responded to our survey were 90% male and 77% baseball players, 73% of which were pitchers. Of the baseball players who responded, 51.9% were in high school at the time of their surgery, 37% college, 6.5% minor leagues, and 2.2% in Major League Baseball. After surgery, 36% of survey responders returned to a higher level of competition than previously. For example, a high school athlete who had UCL reconstruction and went on to pitch in college. Further, 45% returned to the same level, and 7% returned to a lower level. Subjective "satisfaction," was reported in 92% of responders and 97.2% reported that, "having surgery was a good idea." Symptom onset in the responding athletes was 58.9% sudden, and 41.1% gradual. Overall, 90.9% of respondents returned to play in less than 1.5 years while 6.3% never were able to return. Re-tear occurred in 2.5% of patients, while 8.8% had subjective nerve dysfunction for at least 3 months following surgery. CONCLUSION: The Docking Plus technique can produce excellent subjective and objective results in athletes. Further study is warranted to see the effects of this procedure in other settings and determine which method of reconstruction or repair is superior.
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Prevention of Ulnar Collateral Ligament Reconstruction: A Systematic ReviewBackground: Medial ulnar collateral ligament reconstruction surgery (UCLR) is a common surgical procedure performed on elite level baseball players. Physical signs and symptoms of ulnar collateral ligament (UCL) injuries requiring UCLR along with treatment have been clearly defined, however, an exact etiology of UCL injuries and methods of preventing UCLR surgery remain unclear. Objective: Systematically review and qualitatively provide an in-depth summary of recent literature about the relationships between changes in advanced pitching metrics for potential warning signs of UCL injury prior to requiring UCLR. Methods: We searched two electronic databases (PubMed, Scopus) from inception to October 2021 using a keyword search. Data extracted included author and year of publication, study design, sample size, study location, and primary outcome variables. Articles that met inclusion criteria were then evaluated using a modified Downs and Black criteria. Results: The key word search returned 51 articles of which a total of seven articles were included in the review. For the papers that met the inclusion criteria, four noted changes to velocity as potential an indicator for UCLR surgery, two identified lateralization of arm angles as an indicator of UCLR surgery, and one reported change to spin rates of specific pitches as an indicator for UCLR surgery. Conclusions: The results of this review show that changes in certain advanced pitching metrics such as spin rate, velocity, and lateralization of arm angles could be potential indicators of UCL damage. Further evaluation is needed to continue to improve our understanding of how these trends could be used as predictors of UCLR.
