There is a high rate of RTP in professional baseball after UCL reconstruction. Performance declined before surgery and improved after surgery. When compared with demographic-matched controls, patients who underwent UCL reconstruction had better results in multiple performance measures. Reconstruction of the UCL allows for a predictable and successful return to the MLB.

No abstract

Background:Anterior cruciate ligament (ACL) rupture is a significant injury in National Basketball Association (NBA) players.Hypotheses:NBA players undergoing ACL reconstruction (ACLR) have high rates of return to sport (RTS), with RTS the season following surgery, no difference in performance between pre- and postsurgery, and no difference in RTS rate or performance between cases (ACLR) and controls (no ACL tear).Study Design:Case-control.Methods:NBA players undergoing ACLR were evaluated. Matched controls for age, body mass index (BMI), position, and NBA experience were selected during the same years as those undergoing ACLR. RTS and performance were compared between cases and controls. Paired-sample Student t tests, chi-square, and linear regression analyses were performed for comparison of within- and between-group variables.Results:Fifty-eight NBA players underwent ACLR while in the NBA. Mean player age was 25.7 ± 3.5 years. Forty percent of ACL tears occurred in the fourth quarter. Fifty players (86%) RTS in the NBA, and 7 players (12%) RTS in the International Basketball Federation (FIBA) or D-league. Ninety-eight percent of players RTS in the NBA the season following ACLR (11.6 ± 4.1 months from injury). Two players (3.1%) required revision ACLR. Career length following ACLR was 4.3 ± 3.4 years. Performance upon RTS following surgery declined significantly (P < 0.05) regarding games per season; minutes, points, and rebounds per game; and field goal percentage. However, following the index year, controls’ performances declined significantly in games per season; points, rebounds, assists, blocks, and steals per game; and field goal and free throw percentage. Other than games per season, there was no significant difference between cases and controls.Conclusion:There is a high RTS rate in the NBA following ACLR. Nearly all players RTS the season following surgery. Performance significantly declined from preinjury level; however, this was not significantly different from controls. ACL re-tear rate was low.Clinical Relevance:There is a high RTS rate in the NBA after ACLR, with no difference in performance upon RTS compared with controls.

Background:Anterior cruciate ligament (ACL) rupture is a significant injury in male Major League Soccer (MLS) players in the United States.Purpose:To determine (1) return-to-sport (RTS) rate in MLS following ACL reconstruction (ACLR), (2) timing of RTS, (3) performance upon RTS, and (4) the difference in RTS and performance between players who underwent ACL reconstruction (ACLR) and controls.Study Design:Case-control study; Level of evidence, 3.Methods:MLS players undergoing ACLR between 1996 and 2012 were evaluated. Player data were extracted from publically available sources. All demographic data were analyzed. A control group of players matched by age, body mass index (BMI), sex, position, performance, and MLS experience (occurred at 2.6 years into career, designated “index year”) was selected from the MLS during the same years as those undergoing ACLR. The RTS and performance in the MLS were analyzed and compared between cases and controls. Student ttests were performed for analysis of within- and between-group variables.Results:A total of 52 players (57 knees) that met inclusion criteria underwent ACLR while in the MLS. Mean player age was 25.6 ± 3.98 years. Forty players were able to resume play (77%). Of the 40 players (45 knees), 38 (43 knees; 95%) resumed play the season following ACLR (mean, 10 ± 2.8 months after surgery). Mean career length in the MLS after ACLR was 4.0 ± 2.8 years. The revision rate was 10%. There was a significant increase in the incidence of ACL tears in the MLS by year (P < .001), and there was a significantly (P= .002) greater number of ACL tears on the left knee as opposed to the right. Performance in the MLS upon RTS after ACLR was not significantly different versus preinjury. There was no significant difference in survival in the MLS between cases and controls after ACLR or index year. The only significant performance differences between cases and controls were that cases had significantly greater shots taken per season (P= .005) and assists (P= .005) than did controls after the index year.Conclusion:There is a high RTS rate in the MLS following ACLR. Nearly all players resumed play the season after surgery. Performance was not significantly different from preinjury. Only 2 performance measures (shots taken and assists) were significantly different between cases and controls. A significantly greater number of ACL tears occur in the left versus the right knee.

Objectives:Purpose: Overuse injuries to the elbow in the throwing athlete are common. Ulnar collateral ligament reconstruction (UCLR), commonly known as Tommy John surgery, is performed on both recreational and high-level athletes. There is no current literature regarding the incidence and demographic distribution of this surgical procedure in relation to age, location within the Unites States (U.S.), and gender. The purpose of this study is to determine the current demographic distribution of UCLR within the U.S.Methods:Methods: A retrospective analysis of private payer database using the PearlDiver Supercomputer (Warsaw, IN) was performed to identify UCLR procedures performed between the years of 2007-2011. The Current Procedural Code (CPT) 24346 (reconstruction of the ulnar collateral ligament of the elbow with the use of a tendinous graft) was used. Statistical analysis was performed as appropriate using STATA (Version 12.1; Statacorp; College Station, TX, USA).Results:Results: Between 2007-2011, 790 patients underwent UCLR. The overall average annual incidence was 2.16+/- 0.27 per 100,000 patients, but was 31.9 +/-3.9 for patients aged 15-19. The average annual growth was 5.72%. There were 695 males and 95 females. Fifteen to 19 year olds accounted for significantly more procedures than any other age group 56.8% (p<0.001), followed by 20 to 24 year olds 23.4%. The incidence of UCLR in the 15-19 year old group increased at an average rate of 6% per year (incidence rate ratio = 1.06, p=0.025). The south region performed significantly more UCLR than any other region p<0.001. The number of procedures significantly increased over time (p=0.039).Conclusion:Conclusion: UCLR was performed significantly more in patients aged 15-19 than any other age group. The average annual incidence of UCLR per 100,000 people for patients aged 15-19 is 31.9. The number of UCLR is increasing over time. Further work should address risk-reduction efforts in this at-risk population.