Objectives Ulnar collateral ligament (UCL) tears are increasingly common in baseball pitchers. Associated injuries and predisposing pathology are not understood. Previous research. suggests a link between UCL injury in Major League Baseball (MLB) pitchers and proximal lower extremity injuries (hip, hamstrings and groin). We aimed to determine the incidence of proximal lower extremity injuries in UCL reconstruction (UCLR) patients in our cohort of mostly college pitchers. We hypothesized that our cohort would have a similar incidence of proximal lower extremity injuries compared to the MLB pitcher cohort, and a higher incidence than the MLB control group.
Patients who underwent UCLR at our institution from 2015-2018 were identified and surveyed. They were asked about history of athletic hip, hamstring, or groin injuries. This was compared to the previously reported MLB cohorts of pitchers who had UCL injury and the controls.
122 baseball pitchers underwent UCLR in our case series between 2015-2018, 32.8% also had injuries to their proximal lower extremity. Of those with lower extremity injuries, 37.5% had hip injuries, 10% had groin injuries, and 52.5% had hamstring injuries. In the previously reported MLB cohort of 145 pitchers, 27.6% had proximal lower extremity injuries around the time of their UCLR. This was not significantly different from the incidence in our UCLR group (p=0.36). In the MLB control group of 145 pitchers who did not undergo UCLR, 17.9% had proximal lower extremity injuries which was significantly less than our UCLR group as well (p<0.01).
Our cohort of 122 baseball pitchers who underwent UCLR had a higher incidence of proximal lower extremity injury than the MLB control group (OR=2.2) This result mirrors the previously reported MLB findings. Proximal lower extremity injuries are potentially a risk factor for future ulnar collateral ligament injuries in baseball pitchers, larger, prospective study could further evaluate the correlation