Lower MRI grade and humeral location linked to higher survival rates

Professional baseball players with a low-grade elbow injury that occurs on the humeral side of the elbow have a better chance of returning to throw and returning to play, and a lower risk of ulnar collateral ligament surgery than players who suffered more severe injuries on the ulnar side of the elbow. The research was presented at the Annual Meeting of the American Orthopedic Society of Sports Medicine.

Led by Dr. AaKash Chauhan from DuPage Medical Group, Downers Grove, Ill., the team of researchers conducted a study of 544 professional baseball players, average age 22.5 years with 90 percent playing in the Major League Baseball level and 84 percent identified as pitchers.

Chauhan and his team of researchers sought to evaluate the relationship of MRI tear grade and injury location with outcomes for nonoperatively treated elbow ulnar collateral ligament (UCL) injuries in professional baseball players.

There were no statistically significant differences in return to throw, return to pitch and ulnar collateral ligament repair by grade or tear location. However, objectively, ulnar-sided tears had the lowest return to throw rate at 81 percent and return to pitch rate at 42 percent, respectively. Players with ulnar and both-sided tears also had a higher rate of elbow repair surgery compared to players with humeral-side tears.

Chauhan's analysis found that older players were less likely to return to play compared with younger players, and major league players were more likely to suffer re-injury or ulnar collateral ligament surgery than minor league players.

The researchers found that lower MRI grade and humeral location were objectively associated with a higher return to throw, higher return to pitch, lower rate of elbow surgery, and higher survival rates compared to higher grade, and ulnar or both-sided tears. Players who were older than 25 had a significantly higher likelihood of not returning to play after non-operative treatment. Competing at the Major League Baseball level had a higher likelihood of re-injury or having ulnar surgery.

"Based on this study, non-operative treatment of ulnar collateral ligament injuries will likely be more successful in younger players, lower grade tears, and humeral-sided injuries," Chauhan said.

The American Orthopaedic Society for Sports Medicine (AOSSM) is the premier global, sports medicine organization representing the interests of orthopedic surgeons and other professionals who provide comprehensive health services for the care of athletes and active people of all ages and levels. We cultivate evidence-based knowledge, provide extensive educational programming, and promote emerging research that advances the science and practice of sports medicine. AOSSM is also a founding partner of the STOP Sports Injuries campaign to prevent overuse and traumatic injuries in kids.