Should We Limit Innings Pitched Following Ulnar Collateral Ligament Reconstruction in Major League Baseball Pitchers?

OBJECTIVES: Background: Ulnar collateral ligament reconstruction (UCLR) has become a common procedure amongst major league baseball (MLB) pitchers. It is unclear if a limit on innings pitched following UCLR should be instituted to prevent revision UCLR. PURPOSE: To determine whether the number of innings pitched or number of pitches thrown in the first full season following UCLR, as well as the pitcher’s overall MLB career, correlated with need for a revision UCLR HYPOTHESIS: Number of innings pitched and number of pitches thrown following UCLR will not affect whether a pitcher undergoes a revision UCLR. METHODS: Methods: All MLB pitchers between 1974-2015 who pitched at least one full season following UCLR were included. Pitch counts and innings pitched for the first full season following UCLR as well as total pitch count and total innings pitched following UCLR were recorded. Pitch counts and innings pitched were compared amongst players who required revision UCLR and those who did not. RESULTS: Results: Overall, 154 pitchers were included. Of these, 135 pitchers did not require revision UCLR while 19 underwent revision UCLR. No significant difference existed between pitchers who underwent revision UCLR and those who did not in: number of innings pitched in the season following UCLR (p=0.9016), number of pitches thrown in the season following UCLR (p=0.7337), number of innings pitched in the pitcher’s career following UCLR (p=0.6945), and number of pitches thrown in the pitcher’s career following UCLR (p=0.4789). Furthermore, no difference existed in revision rate between pitchers who pitched more or less than 180 innings in the first full season following UCLR (p=0.6678). CONCLUSION: Conclusion: The number of innings pitched and number of pitches thrown in the first full season as well as over a player’s career following UCLR does not appear to increase a player’s risk of revision UCLR.