دورية أكاديمية
The Utility of Stress Ultrasound in Identifying Risk Factors for Elbow Ulnar Collateral Ligament Tear: A Longitudinal Study of 203 Professional Baseball Players.
| العنوان: | The Utility of Stress Ultrasound in Identifying Risk Factors for Elbow Ulnar Collateral Ligament Tear: A Longitudinal Study of 203 Professional Baseball Players. |
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| المؤلفون: | Hanna AJ; Department of Orthopaedic Surgery, Rothman Institute, Philadelphia, Pennsylvania, USA.; Rowan-Virtua School of Osteopathic Medicine, Stratford, New Jersey, USA., Popper HR; Department of Orthopaedic Surgery, Jefferson Health New Jersey, Stratford, New Jersey, USA., Sonnier JH; Department of Orthopaedic Surgery, Rothman Institute, Philadelphia, Pennsylvania, USA., Erickson BJ; Department of Orthopaedic Surgery, Rothman Institute, Philadelphia, Pennsylvania, USA., Jack RA 2nd; Houston Methodist Orthopedics & Sports Medicine, Houston, Texas, USA., Cohen SB; Department of Orthopaedic Surgery, Rothman Institute, Philadelphia, Pennsylvania, USA. |
| المصدر: | The American journal of sports medicine [Am J Sports Med] 2024 Mar; Vol. 52 (4), pp. 1060-1067. Date of Electronic Publication: 2024 Feb 26. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Sage Publications Country of Publication: United States NLM ID: 7609541 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1552-3365 (Electronic) Linking ISSN: 03635465 NLM ISO Abbreviation: Am J Sports Med Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2004- : Thousand Oaks, CA : Sage Publications Original Publication: Baltimore, Williams & Wilkins. |
| مواضيع طبية MeSH: | Collateral Ligament, Ulnar*/injuries , Baseball*/injuries , Elbow Joint*/diagnostic imaging , Elbow Joint*/surgery , Ulnar Collateral Ligament Reconstruction* , Collateral Ligaments*/diagnostic imaging , Collateral Ligaments*/surgery, Humans ; Elbow/surgery ; Cohort Studies ; Longitudinal Studies ; Risk Factors |
| مستخلص: | Background: Injuries to the medial ulnar collateral ligament (UCL) are common among baseball pitchers due to repetitive stress on the soft tissue stabilizers of the elbow during pitching. Dynamic stress ultrasound (SUS) can be used to evaluate the UCL and ulnohumeral joint to identify anatomic risk factors of those who will require UCL reconstruction (UCLR). Purpose: To determine whether any adaptive or morphological changes detectable on SUS can predict injury to the UCL in professional baseball pitchers. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 203 professional baseball pitchers who underwent SUS at preseason training sessions over the course of 18 years were categorized into 1 of 2 groups: those without a history of shoulder, arm, elbow, or forearm surgery or injuries (healthy cohort; n = 184) and those who underwent UCLR the same season as SUS (UCLR cohort; n = 19). Ligament thickness, joint spacing, and laxity were compared. An additional matched cohort analysis was conducted using 10 players from each group to detect differences in the progression of UCL and ulnohumeral joint measures in the year before injury. Results: The UCLR cohort, when compared with the healthy cohort, had higher relative (ie, nondominant-side measurements subtracted from dominant-side measurements) resting ulnohumeral joint space (median, 0.50 vs 0.20 mm, respectively; P = .006) and higher rates of hypoechoic foci (57.9% vs 30.4%, respectively; P = .030). Players of both groups had similar dominant UCL thickness ( P = .161), ulnohumeral joint space at rest ( P = .321), space under stress ( P = .498), and laxity ( P = .796). Groups did not differ in terms of relative UCL thickness, ulnohumeral joint space under stress, or relative laxity. In the year before UCL injury, the UCLR cohort, compared with the matched healthy cohort, had a greater increase in mean dominant UCL thickness (0.94 vs -0.60 mm, respectively; P = .038) and a greater increase in relative median UCL thickness (1.35 vs -0.35 mm, respectively; P = .045). Players in the healthy cohort were statistically older than those in the UCLR cohort (23 vs 22 years, respectively; P = .004). No differences in ulnohumeral stress spacing or laxity were detected. Conclusion: SUS of players who underwent UCLR demonstrated a progressive increase in UCL thickness over 1 year, higher rates of hypoechoic foci, and increased ulnohumeral rest space compared with SUS of uninjured players. Competing Interests: One or more of the authors has declared the following potential conflict of interest or source of funding: B.J.E. has received consulting fees from Arthrex and DePuy Synthes Products; research support from Arthrex, DePuy, Linvatec, Smith + Nephew, and Stryker; support for education from Gotham Surgical Solutions & Devices, Smith + Nephew, and Pinnacle Inc; and hospitality payments from Wright Medical Technology, Liberty Surgical, and Stryker. R.A.J. has received consulting fees from Zimmer Biomet Holdings and support for education from Medinc of Texas, Smith + Nephew, and Liberty Surgical. S.B.C. has received research support from Arthrex and Major League Baseball; consulting fees from CONMED Linvatec and Zimmer Biomet Holdings; and support for education from Liberty Surgical. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto. |
| فهرسة مساهمة: | Keywords: Major League Baseball; injury; stress ultrasound; ulnar collateral ligament |
| تواريخ الأحداث: | Date Created: 20240226 Date Completed: 20240318 Latest Revision: 20240318 |
| رمز التحديث: | 20240318 |
| DOI: | 10.1177/03635465241230049 |
| PMID: | 38406885 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1552-3365 |
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| DOI: | 10.1177/03635465241230049 |