TY - JOUR
T1 - Return to Sport Following Shoulder Surgery in the Elite Pitcher
T2 - A Systematic Review
AU - Harris, Joshua D.
AU - Frank, Jonathan M.
AU - Jordan, Mark A.
AU - Bush-Joseph, Charles A.
AU - Romeo, Anthony A.
AU - Gupta, Anil K.
AU - Abrams, Geoffrey D.
AU - McCormick, Frank M.
AU - Bach, Bernard R.
N1 - Funding Information:
The following authors declared potential conflicts of interest: Charles A. Bush-Joseph, MD, is a board member of the American Orthopaedic Society for Sports Medicine and receives research support from Arthrex, Inc., Linvatec, Smith and Nephew, and Ossur; Anthony A. Romeo, MD, is a consultant, receives royalties and payments for lectures, has patents from Arthrex, Inc., and has received grants from DJO Surgical, Smith and Nephew, Ossur, and AANA; and Bernard R. Bach, Jr., MD, has received royalties from SLACK, Inc., and receives research support from Arthrex, Inc., Linvatec, Smith and Nephew, and Ossur.
PY - 2013/7
Y1 - 2013/7
N2 - Context: The ability to return to elite pitching, performance, and clinical outcomes of shoulder surgery in elite baseballpitchers are not definitively established.Objective: To determine (1) the rate of return to sport (RTS) in elite pitchers following shoulder surgery, (2) postoperativeclinical outcomes upon RTS, and (3) performance upon RTS and to compare RTS rates in different types of shoulder surgery.Data Sources: Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines andchecklist, Medline, SciVerse Scopus, SportDiscus, and Cochrane Central Register of Controlled Trials were searched.Study Selection: Levels I-IV evidence were eligible for inclusion if performance-based (eg, RTS) and/or clinical outcome-based reporting of outcomes were reported following surgical treatment of shoulder pathology in elite pitchers (major orminor league or collegiate).Data Extraction: Subject, shoulder, and pre- and postoperative performance-based variables of interest were extracted.All shoulder surgery types were potentially inclusive (eg, open, arthroscopic, rotator cuff, labrum, biceps, acromioclavicularjoint, fracture). Study methodological quality was analyzed using the Modified Coleman Methodology Score (MCMS).Results: Six studies were analyzed (287 elite male pitchers [mean age, 27 years] who underwent shoulder surgery, with99% on the dominant, throwing shoulder). MCMS was 38 (poor). Most pitchers were professional, with a mean career lengthof 6.58 years and postoperative clinical follow-up of 3.62 years. In 5 of 6 studies, multiple diagnoses were addressed concomitantlyat surgery. Rate of RTS was 68% at mean 12 months following surgery. Twenty-two percent of Major LeagueBaseball (MLB) pitchers never RTS in MLB. Overall performance did improve following surgery; however, this did notimprove to pre-injury levels.Conclusion: In this systematic review, the rate of return to elite baseball pitching following surgery was established.Performance tended to decrease prior to surgery and gradually improve postoperatively, though not reaching pre-injury levelsof pitching.Level of Evidence: IV (systematic review of studies level I-IV evidence), therapeutic.
AB - Context: The ability to return to elite pitching, performance, and clinical outcomes of shoulder surgery in elite baseballpitchers are not definitively established.Objective: To determine (1) the rate of return to sport (RTS) in elite pitchers following shoulder surgery, (2) postoperativeclinical outcomes upon RTS, and (3) performance upon RTS and to compare RTS rates in different types of shoulder surgery.Data Sources: Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines andchecklist, Medline, SciVerse Scopus, SportDiscus, and Cochrane Central Register of Controlled Trials were searched.Study Selection: Levels I-IV evidence were eligible for inclusion if performance-based (eg, RTS) and/or clinical outcome-based reporting of outcomes were reported following surgical treatment of shoulder pathology in elite pitchers (major orminor league or collegiate).Data Extraction: Subject, shoulder, and pre- and postoperative performance-based variables of interest were extracted.All shoulder surgery types were potentially inclusive (eg, open, arthroscopic, rotator cuff, labrum, biceps, acromioclavicularjoint, fracture). Study methodological quality was analyzed using the Modified Coleman Methodology Score (MCMS).Results: Six studies were analyzed (287 elite male pitchers [mean age, 27 years] who underwent shoulder surgery, with99% on the dominant, throwing shoulder). MCMS was 38 (poor). Most pitchers were professional, with a mean career lengthof 6.58 years and postoperative clinical follow-up of 3.62 years. In 5 of 6 studies, multiple diagnoses were addressed concomitantlyat surgery. Rate of RTS was 68% at mean 12 months following surgery. Twenty-two percent of Major LeagueBaseball (MLB) pitchers never RTS in MLB. Overall performance did improve following surgery; however, this did notimprove to pre-injury levels.Conclusion: In this systematic review, the rate of return to elite baseball pitching following surgery was established.Performance tended to decrease prior to surgery and gradually improve postoperatively, though not reaching pre-injury levelsof pitching.Level of Evidence: IV (systematic review of studies level I-IV evidence), therapeutic.
KW - arthroscopy
KW - Major League Baseball
KW - pitcher
KW - shoulder
KW - surgery
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U2 - 10.1177/1941738113482673
DO - 10.1177/1941738113482673
M3 - Review article
AN - SCOPUS:84879176114
SN - 1941-7381
VL - 5
SP - 367
EP - 376
JO - Sports Health
JF - Sports Health
IS - 4
ER -