The American journal of sports medicine
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Injuries remain a significant problem for professional baseball players. There is little information regarding the incidence and outcomes of shoulder surgical procedures among these athletes. ⋯ Shoulder surgery is uncommon among professional baseball players. Of those players who require surgery, the majority are pitchers and minor league players. Most procedures involve the labrum. Rotator cuff tears are mostly articular-sided supraspinatus tears. The overall RTS rate is 63%. Of those who return, 86% are able to return to the same or higher level of play as before surgery.
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Isolated ulnar nerve decompression/transposition is an uncommon surgical procedure among professional baseball players. ⋯ Anterior subcutaneous transposition is the most common surgical procedure among professional baseball players to address ulnar neuropathy at the elbow. Players have a 62% rate of RTS, which is lower than expected for this nonreconstruction or repair procedure. For players who successfully RTS, performance metrics versus matched controls remained the same except for allowing significantly more walks per 9 innings. Postoperatively, pitchers with UCLR before ulnar nerve decompression/transposition who had a successful RTS performed the same as matched controls with prior UCLR without subsequent ulnar nerve decompression/transposition.
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Professional baseball pitchers are at high risk for tears of the ulnar collateral ligament (UCL) of the elbow, often requiring surgical reconstruction. Despite acceptable published return-to-play outcomes, multiple techniques and graft types have been described. ⋯ Surgical outcomes in professional baseball players are not significantly influenced by UCLR technique or graft type. There was a high rate (46.3%) of subsequent throwing elbow injuries. MLB pitchers were more likely to RTP and RSL, but they had a higher frequency of subsequent elbow and forearm injuries than MiLB pitchers. Both the docking technique and the palmaris longus autograft are increasing in popularity among surgeons treating professional baseball players.
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Latissimus dorsi and teres major (LD/TM) tears are becoming an increasingly common cause of injury and disability among professional baseball pitchers. ⋯ The majority of LD/TM tears are treated nonoperatively. The RTS rate is 75% for professional baseball pitchers after LD/TM tears treated operatively or nonoperatively. Players treated nonoperatively saw a decline in several performance metrics, while players treated operatively had no significant difference in performance after surgery.
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Little is known regarding the rates and risk factors for long-term postoperative opioid use among opioid-naïve patients undergoing elective shoulder surgery. ⋯ Most patients were opioid naïve before elective shoulder surgery; however, among opioid-naïve patients, 1 in 7 patients were still using opioids beyond 180 days after surgery. Among all variables, a history of mental illness most significantly increased the risk of long-term opioid use after elective shoulder surgery.