26 Aug May Be No Need For A Pitch Restriction After Tommy John Surgery

MedicalResearch.com Interview with:

Dr. Brandon Erickson

Brandon J. Erickson, MD
Midwest Orthopaedics
Rush, Rush University Medical Center
Chicago, IL

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Ulnar collateral ligament reconstruction (UCLR), also known as Tommy John surgery has become a common procedure amongst major league baseball (MLB) pitchers. It is unclear if a limit on innings pitched following Tommy John surgery should be instituted to prevent revision Tommy John surgery.

The purpose of this study was to determine if innings pitched following Tommy John surgery is associated with an increased risk of revision Tommy John surgery amongst MLB pitchers. To answer this question we located all MLB pitchers between 1974-2015 who pitched at least one full season following their Tommy John surgery and included them in our analysis. Pitch counts and innings pitched for the first full season following Tommy John surgery as well as total pitch count and total innings pitched over the course of the player’s career were recorded.

Pitch counts and innings pitched were compared amongst players who required revision Tommy John surgery and those who did not. We were able to include 154 pitchers. Of these, 135 pitchers did not require revision Tommy John surgery while 19 underwent revision Tommy John surgery.  No significant difference existed between pitchers who underwent revision Tommy John surgery and those who did not when comparing number of innings pitched in the season following Tommy John surgery,  number of pitches thrown in the season following Tommy John surgery,  number of innings pitched in the pitcher’s career following Tommy John surgery and number of pitches thrown in the pitcher’s career following Tommy John surgery.  Furthermore, no difference existed in revision rate between pitchers who pitched more or less than 180 innings in the first full season following Tommy John surgery.

MedicalResearch.com: What should readers take away from your report?

Response: The important take home points from the study are that when you look at MLB pitchers who have undergone Tommy John Surgery, the number of innings pitched and number of pitches thrown in the first full season as well as over a player’s career following their Tommy John Surgery has no impact on their need for a revision Tommy John surgery. Essentially pitchers do not have to have an inning limit or pitch count limit for the season placed on them when they return from their Tommy John surgery.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: There is still much that needs to be learned surrounding Tommy John surgery both in professional as well as youth baseball pitchers. Although it does not appear pitch counts and inning limits play a role in whether or not an MLB pitcher needs a second Tommy John surgery, there may be other factors such as rehabilitation protocols, different surgical techniques, and how long it takes these players to return to play following surgery that can have an effect on whether or not they need a second surgery.

MedicalResearch.com: Is there anything else you would like to add?

Response: While this is the first study to look at pitch counts and innings pitched in MLB pitchers following Tommy John surgery, players, coaches, etc. must understand that treatment for these athletes should be tailored each individual player. While our study did not find a correlation between innings pitched or pitches thrown in the player’s first season back following Tommy John surgery and need for a second Tommy John surgery down the line, the amount of use a pitcher gets in his first full season back should be based on a discussion between the player, trainer, coach, and treating doctor.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:
Brandon J. Erickson, Gregory L. Cvetanovich, Bernard R. Bach, Jr, Charles A. Bush-Joseph, Nikhil N. Verma, and Anthony A. Romeo
Should We Limit Innings Pitched After Ulnar Collateral Ligament Reconstruction in Major League Baseball Pitchers? Am J Sports Med July 11, 2016 ; published online before print July 11, 2016,doi:10.1177/0363546516643813

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

More Medical Research Interviews on MedicalResearch.com

[wysija_form id=”5″]

Last Updated on August 26, 2016 by Marie Benz MD FAAD