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2021 AOSSM-AANA Combined Annual Meeting Recordings
Ulnar Collateral Ligament Injuries in Gymnasts and ...
Ulnar Collateral Ligament Injuries in Gymnasts and Javelin Throwers: An Analysis of Return to Sport and Patient Outcomes
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Video Transcription
I'd like to thank AOSSM and Anna for the opportunity to present this work and thank my co-authors for their help as well. Relevant disclosures can be found on the Academy website. So UCL injuries are common in overhead athletes, most notably baseball players, and surgery has allowed these athletes to return to play at a high rate, and the number of UCL reconstructions is increasing in frequency and has more than doubled in the past decade. The purpose of these projects were to evaluate return to play and the patient-reported outcome measures in a unique group of athletes who placed a supraphysiologic load on the elbow similar to baseball players. Both studies were Level 4 Retrospective Case Series. Twelve consecutive gymnasts and 18 javelin throwers who underwent UCL reconstruction and were available for minimum two-year follow-up were included. Nine of the 12 gymnasts and 16 of the 18 javelin throwers were available for phone call follow-up and completed the patient-reported outcome measures that can be seen above. For the gymnasts, all were female, and eight of the nine reported an acute injury during a gymnastics maneuver, most frequently a variation of a handspring. All five complete tears were treated operatively, and all four partial tears were initially treated non-operatively. One patient elected to undergo surgery at an outside hospital from this group. Three of the nine patients reported complete resolution of symptoms, and all three of these patients were treated surgically. Overall, seven of the nine gymnasts returned to sport at an average of 7.3 months from date of injury. At final follow-up, the operative group did significantly better on multiple objective measures, which can be seen here. Both patients who did not return to play for the gymnastics cohort reported that the reason for retiring was persistent symptoms. Overall, the general satisfaction for patients was high in both groups, with objective measures showing superiority to surgical management. For the gymnasts, 14 of the 16 available for follow-up were males, and all underwent surgery with 75% of them having surgery done using a modified joke technique. Similar to the gymnastics cohort, patients were overall satisfied with their outcomes, and 12 of the 16 patients reported complete resolution of their symptoms. When looking at those who did and did not return to play, no significant differences were seen between Kajak and Andrews-Timmerman scores. Ten of the 16 javelin throwers were able to return to competition, and they did so at an average of 12.2 months from injury. Of those unable to return to play, four of the six reported that their reason for doing so was expiration of their college eligibility. The two other patients reported that they retired for reasons unrelated to their elbows. Overall, in this unique group of athletes who sustained UCL injuries, patients were generally satisfied with their outcomes and returned to sport at a high rate. For the gymnasts, objective measures pointed towards slight superiority of surgically treated patients, while in the javelin throwing group, no athlete failed to return to play because of continued problems with their elbow. Limitations of the study include its retrospective nature and relatively small sample size, and more data is needed on UCL injuries and their outcomes for non-baseball playing athletes. Overall, gymnasts and javelin throwers did well with surgical treatment. Thank you. Thank you, Taylor. If you can have a seat at the podium.
Video Summary
In this video presentation, the speaker discusses UCL injuries in overhead athletes, particularly baseball players. Surgical intervention for UCL injuries has resulted in a high rate of return to play, and the number of UCL reconstructions has increased in recent years. The speaker conducted two studies to evaluate the return to play and patient-reported outcomes in a unique group of athletes who placed a supraphysiologic load on their elbows, similar to baseball players. The studies included 12 gymnasts and 18 javelin throwers who underwent UCL reconstruction. Results showed that most patients were satisfied with their outcomes and were able to return to sport, with surgical treatment showing better objective measures in the gymnast group. However, there were limitations to the study, including its retrospective nature and small sample size.
Asset Caption
Taylor D'Amore, MD
Keywords
UCL injuries
overhead athletes
baseball players
surgical intervention
return to play
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