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    Location of UCL Tears in MLB Pitchers Can Help Determine if Surgery is Necessary

    An ulnar collateral ligament (UCL) injury can have a big impact on a Major League Baseball (MLB) pitcher’s career longevity, making treatment decisions a challenge for physicians.

    Research from the Cleveland Clinic Sports Health Center presented at the American Orthopaedic Society for Sports Medicine’s recent Annual Meeting in Colorado Springs, Colorado, showed that the location of ligament tears within the elbow can be key to predicting the success of non-operative treatment for these injuries, and deciding whether surgery should be recommended.

    “The goal of our research was to see if an objective measure like physical examination or imaging from an MRI could help predict non-operative treatment failures in these professional pitchers,” said senior author Mark S. Schickendantz, MD.

    “We determined that distal tears, involving where the ligament attaches to the bone across the joint, had higher rates of failure when not treated with surgery as compared to proximal tears.”

    The study included pitchers who sustained UCL injuries between 2006 and 2015 from 1 professional baseball organization, including major and minor league teams.

    A total of 38 players with a UCL injury were identified, of which 32 (84%) received non-operative treatment for partial ligament tears. A proximal tear of the UCL was identified in 81% of the patients who were successfully treated non-operatively.

    By contrast, a distal tear of the UCL was detected in patients who failed non-operative treatment and required surgical intervention.

    “This data gives us a great starting point for using imaging to better prescribe a treatment protocol for professional pitchers,” said Dr. Schickendantz.

    “We can see that pitchers were 12.4 times more likely to fail non-operative treatment with a distal ligament tear, which is significant.”

    The study is the first to isolate variables that demonstrate successes and failures when it comes to treating professional pitchers with UCL injuries non-operatively.