Return to Sport and Sports-Specific Outcomes Following Ulnar Collateral Ligament Reconstruction in Adolescent Athletes:
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REVIEW ARTICLE
Return to Sport and Sports-Specific Outcomes Following Ulnar Collateral Ligament Reconstruction in Adolescent Athletes: A Systematic Review Georgina Glogovac, MD
& Rafael
Kakazu, MD & Alexander Constantine Aretakis, BA & Brian M. Grawe, MD
Received: 13 December 2018/Accepted: 18 April 2019 * Hospital for Special Surgery 2019
Abstract Background: The incidence of elbow injuries and ulnar collateral ligament (UCL) reconstruction in adolescent athletes is increasing. Knowledge and expectations of outcomes following this procedure are necessary for proper counseling and decision-making in this age group. Questions/Purposes: We sought to report patient-reported outcomes, rate of return to sport, and rate of complications and reoperation following UCL reconstruction in adolescent athletes. Methods: A systematic review was conducted for adolescent athletes undergoing UCL reconstruction. The primary outcome measure was patientreported outcome scores, specifically the Conway Scale, the Andrews-Timmerman score, and the Kerlan-Jobe Orthopaedic Clinic (KJOC) score. Secondary outcome measures included return to sport, rate of subsequent procedures, and complication rate. A descriptive analysis was performed. Results: Seven studies met the inclusion criteria. The average patient-reported outcome scores ranged from 81 to 87% (Conway, Bexcellent^), 83.6 to 92.7 (Andrews-Timmerman), and 76 to 89.3 (KJOC). The average rates of return to sport were 84% to preinjury level or higher, 93% to any level, and 57% to a higher level. Complication rates ranged from 0.7 to 11%. Rate of subsequent elbow procedures ranged from 0 to 10%. Conclusions: This systematic review demonstrates favorable outcomes in adolescent athletes following UCL reconstruction. Patient-reported outcome scores and rates of return to sport were comparable with those reported in adult athletes. The procedure is not Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11420-019-09689-9) contains supplementary material, which is available to authorized users. G. Glogovac, MD (*) : R. Kakazu, MD : A. C. Aretakis, BA : B. M. Grawe, MD Department of Orthopaedics and Sports Medicine, University of Cincinnati, 231 Albert Sabin Way, Cincinnati, OH 45267, USA e-mail: [email protected]
without risk of complications, and patients and parents should be counseled regarding this risk prior to surgery. Keywords adolescent . baseball . pitching . ulnar collateral ligament reconstruction
Introduction The medial ulnar collateral ligament (UCL) stabilizes the elbow against valgus stress and is most commonly injured in overhead-throwing athletes. Injury to the ligament is thought to be caused by an accumulation of microtrauma secondary to repetitive stress sustained during the overhead-throwing motion [21]. A tear of the ligament was career-ending for professional baseball pitchers, until the first UCL reconstruction was performed by orthopedic surgeon Frank Jobe in 1974. The procedure has since returned numerous profe
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