•  
  •  
 

Keywords

Health Care Competency

Abstract

An injury to the ulnar collateral ligament (UCL) is sustained through repetitive valgus motions, increasing in prevalence across all levels of baseball due to the increasing workload demands placed on the medial elbow in pitching. Traditionally, UCL tears have been managed through reconstructions followed by a lengthy rehabilitation process. In recent years, the UCL repair with suture augmentation has gained favor given the enhanced patient and clinician outcomes in return-to-play timelines, decreased medial gapping, improved Kerlan Jobe Orthopedic Clinic (KJOC) scores, and long-term functionality. Utilizing 4 databases (MEDLINE, Embase Cochrane library, Science Direct, and Scopus), literature was obtained addressing the pertinent outcomes to compare the 2 surgical options for the UCL tear. Within this review, a total of 17 studies were included consisting of 8 biomechanical and 9 clinical studies. The UCL repair with the suture augmentation yielded excellent KJOC scores >90%, a quicker return-to-sport timeline averaging 4 to 7 months, and a residual complication rate of 8.7%. The repair proves a sustainable treatment option within baseball pitchers to promote a safe return to play while also ensuring a decreased risk of future complications that could significantly impact athletic performance. Healthcare providers working with patients on a baseball team need to understand the risk factors and prevention methods for UCL injuries and adequately educate the necessary stakeholders to help decrease the prevalence. It is also imperative to provide the patient with the autonomy to help make treatment decisions with the health care providers based on available evidence, clinical expertise, and patient values. While UCL repairs with internal bracing can be a feasible option, this review further highlights the need to not discredit UCL reconstructions as a viable treatment, while keeping whole patient healthcare at the center of the patient’s care plan.

Share

COinS