Epidemiology of acromioclavicular joint injuries in professional baseball: analysis from the Major League Baseball Health and Injury Tracking System

Abstract

Background: Shoulder injuries account for a large portion of all recorded injuries in professional baseball. Much is known about other shoulder pathologies in the overhead athlete, but the incidence and impact of acromioclavicular (AC) joint injuries in this population are unknown. We examined the epidemiology of AC joint injuries in Major League Baseball (MLB) and Minor League Baseball (MiLB) players and determined the impact on time missed. Methods: The MLB Health and Injury Tracking System was used to compile records of all MLB and MiLB players from 2011 to 2017 with documented AC joint injuries. These injuries were classified as acute (sprain or separation) or chronic (AC joint arthritis or distal clavicular osteolysis), and associated data extracted included laterality, date of injury, player position, activity, mechanism of injury, length of return to play, and need for surgical intervention. Results: A total of 312 AC joint injuries (183 in MiLB players and 129 in MLB players; range, 39-60 per year) were recorded: 201 acute (64.4%) and 111 chronic (35.6%). A total of 81% of acute and 59% of chronic injuries resulted in time missed, with a mean length of return to play of 21 days for both. Of the injuries in outfielders, 79.6% were acute (P < .0001), as were 66.3% of injuries in infielders (P ¼ .004). Pitchers and catchers had more equal proportions of acute and chronic AC injuries (P > .05 for all). Acute AC injuries occurred most often while fielding (n ¼ 100, 84.7%), running (n ¼ 25, 80.6%), and hitting (n ¼ 19, 61.3%), whereas chronic injuries tended to be more common while pitching (n ¼ 26, 68.4%). Of contact injuries, 82.5% were acute (P < .0001), whereas 59.0% of noncontact injuries were chronic (P ¼ .047). MLB players showed consistently higher regular-season rates of both acute and chronic AC injuries than MiLB players (P < .0001 for each). Conclusion: Acute AC joint injuries are contact injuries occurring most commonly among infielders and outfielders while fielding that result in 3 weeks missed before return to play, whereas chronic AC joint injuries occur more commonly in pitchers and catchers from noncontact repetitive overhead activity. Knowledge of these data can better guide expectation management in this elite population to better elucidate the prevalence of 2 common injury patterns in the AC joint. The Institutional Review Board of the Johns Hopkins University approved this study; the study procedures have been approved by the Johns Hopkins Bloomberg School of Public Health Institutional Review Board.

Inestabilidad acromioclavicular crónica tratada mediante reconstrucción anatómica de los ligamentos coracoclaviculares: plastia tipo Mazzocca

“…Por tal motivo es importante seguir el protocolo radiográfico antes mencionado. [13][14][15] El uso de las escalas funcionales debe realizarse previo al manejo y posterior al mismo.…”

Acromioclavicular Joint Injuries in Sport

“…Sport-related shoulder injuries are among the most common injuries in athletes ranging from high school to elite levels (1)(2)(3)(4)(5)(6)(7). Acromioclavicular (AC) joint (ACJ) injuries account for up to half of shoulder injuries among athletes (1)(2)(3)(4)(5)6,8). As athletes with low-grade ACJ injuries may not seek medical attention, the true incidence of this injury may be underreported.…”

“…As athletes with low-grade ACJ injuries may not seek medical attention, the true incidence of this injury may be underreported. ACJ injuries (also known as subluxation, dislocation, or separation) may occur in a variety of contact and noncontact sports (1)(2)(3)(4)(5)6,8,9). The incidence of ACJ injuries is the highest in American football, soccer, snowboarding, skiing, ice hockey, baseball, wrestling, martial arts, lacrosse, and rugby.…”

“…The incidence of ACJ injuries is the highest in American football, soccer, snowboarding, skiing, ice hockey, baseball, wrestling, martial arts, lacrosse, and rugby. ACJ injuries occur mainly among male athletes in their third decade of life (1)(2)(3)(4)(5)6,8,9). In this article, we will highlight basic elements of ACJ injuries among athletes and discuss evidence on how to manage them.…”

The German version of the Nottingham Clavicle Score is a reliable and valid patient-reported outcome measure to evaluate patients with clavicle and acromioclavicular pathologies

“…Clavicle fractures and acromioclavicular joint (ACJ) dislocations are frequent injuries affecting mostly young, active patients [ 18 , 25 , 33 – 35 , 39 ]. Together with the rarer injuries of the sternoclavicular joint (SCJ) and with degenerative conditions of both ACJ and SCJ affecting elderly patients, these pathologies may impair everyday- and professional- and recreational-life as well as the function of the whole upper limb, chest external appearance, and cosmesis [ 15 , 19 , 24 , 27 , 28 , 38 , 42 ].…”