Media perceptions of Tommy John surgery.

OBJECTIVES: The prevalence of medial ulnar collateral ligament (UCL) reconstruction is increasing in professional athletes and the delivery of baseball news by the media exerts a powerful influence on public opinion of the injury and surgery. The purpose of this investigation was to examine the media's perception regarding the causes of UCL injury as well as the indications, risks, benefits, and rehabilitation related to UCL reconstruction. STUDY DESIGN: Cross-sectional survey study, Level 3. METHODS: This study utilized an online thirty-question survey designed to assess an individual's perception of UCL reconstruction with regard to risk factors for injury, indications, benefits, surgical details, and rehabilitation. Eligible study participants were members of the media including print, internet, radio and/or television directly involved in the coverage of Major League Baseball (MLB). RESULTS: A total of 516 members of the media with a mean age of 43.6 years completed the survey. In nearly half (47.8%), professional baseball represented 76-100% of their total sports coverage responsibility. INDICATIONS: although the majority answered correctly, 45% did not know if an athlete needed an elbow injury as a prerequisite for UCL reconstruction and 25% believed the primary indication was performance enhancement. As percentage of baseball coverage increased, media members were less likely to believe that an elbow injury was not required (p = 0.038). BENEFITS: eighty percent recognized that pitching speed is typically reduced following surgery, but the remaining 20% felt that velocities actually increased compared with pre-injury velocities. Return to play: fifty-two percent overestimated the ability of pitchers to return to back to professional baseball and 51.2% believed return would occur in 12 or less months. Estimates were higher in those of older age (p = 0.032) and increased percentage of baseball coverage (p < 0.001). Overuse injuries: less than half (48.4%) believed the use of pitch counts to be important in the prevention of UCL injury and 33.2% felt that throwing injuries were not preventable in adolescent baseball. CONCLUSION: Common misconceptions exist regarding UCL reconstruction within the professional baseball media. Efforts for physicians to educate the media on the risks of overuse throwing injuries with emphasis on accurate indications, outcomes, and recovery of Tommy John Surgery are encouraged.

Prevalence of Ulnar Collateral Ligament Surgery in Professional Baseball Players.

BACKGROUND: While the high rate of ulnar collateral ligament (UCL) injuries in professional baseball is widely discussed in the media and medical literature, the actual prevalence of UCL reconstruction has not been documented. HYPOTHESIS: The prevalence of UCL reconstruction will be higher among pitchers than nonpitchers, and Major League Baseball (MLB) pitchers will have a higher prevalence than will minor league pitchers. STUDY DESIGN: Descriptive epidemiology study. METHODS: An online questionnaire was distributed to all 30 MLB organizations. Certified athletic trainers from each team administered the questionnaire to all players in the organization, including major league players and 6 levels of minor league players. Demographic data were compared between major and minor league players. Continuous variables (age, years of professional baseball, country of origin, etc) were compared with Student t tests (P < .05). Categorical variables (level, position, etc) were compared using chi-square analysis (P < .05). RESULTS: A total of 5088 professional baseball players (722 major league and 4366 minor league) participated in the survey. Pitchers represented 53% of all players, and 497 players reported at least 1 UCL reconstruction, demonstrating a prevalence rate of 10% (497 of 5088). Pitchers reported a significantly higher prevalence of UCL reconstruction (16%; 437 of 2706) than nonpitchers (3%; 60 of 2382; P < .001). Among major league pitchers, 25% (96 of 382) had a history of UCL reconstruction, while minor league pitchers showed a 15% (341 of 2324) prevalence (P < .001). Major league pitchers were also significantly older (28.8 ± 3.9 years) than minor league pitchers (22.8 ± 3.0; P < .001). The majority of major leaguers (86%) had their UCL reconstruction as professional pitchers, whereas the majority of minor league pitchers (61%) underwent their UCL reconstruction during high school and college (P < .001). The rates of UCL revision, prior elbow surgery, prior shoulder surgery, and types of UCL graft were similar between the major league and minor league pitchers. No difference in prevalence was shown between pitchers born in the United States versus Latin American countries. CONCLUSION: Pitchers have a high prevalence of UCL reconstruction in professional baseball, with 25% of major league pitchers and 15% of minor league pitchers having a history of the surgery.