Outcomes and factors of elbow arthroscopy upon returning to sports for throwing athletes with osteoarthritis.

BACKGROUND: Elbow arthroscopy had good functional outcome for throwing athletes. Returning to sports is a major concern for all athletes, but only a few reports have investigated the clinical factors related to the duration of returning to sports. The present study evaluates the efficacy of elbow arthroscopic surgery on throwing elbows with osteoarthritis and defines the clinical factors related to the duration of the returning to sports. METHODS: This was a retrospective study with fifteen active baseball throwing athletes with elbow osteoarthritis who were treated with elbow arthroscopy. Perioperative clinical factors were analyzed for functional outcomes. A multiple linear regression analysis was used to analyze the clinical factors associated with the duration of returning to training and sports. RESULTS: The 15 patients' mean age was 27 years. The mean follow-up time was 2.6 years. The mean procedural complexity was 3.1 ± 1.6 (range 1-6). The elbow total range of motion (ROM) improved significantly from 100.7 ± 28.7° to 125.7 ± 18.5° (p = 0.001). The terminal flexion range of the elbow increased significantly from 116.0 ± 22.6° to 130.0 ± 13.2° (p = 0.001), and the terminal extension range improved from 15.3 ± 11.1° to 4.3 ± 5.9° (p = 0.001). Before the operation, the average subjective patient outcome for return to sports (SPORTS) score was 3.4 ± 1.5, which increased significantly to 9.67 ± 0.45 (p = 0.003) at the last follow-up. The multiple linear regression analysis revealed that higher procedural complexity hinders the athletes from returning to competition. CONCLUSIONS: Elbow arthroscopy offered highly satisfactory results in the throwing elbows of elite athletes and significantly improved the range of motion and SPORTS score. The procedural complexity was significantly related to the duration of returning to competition. Early and aggressive arthroscopic intervention is recommended for elite throwing athletes with elbow osteoarthritis who fail to respond to conservative treatment.

Injury Trends in Major League Baseball Over 18 Seasons: 1998-2015.

Since Major League Baseball (MLB) expanded to its current size of 30 teams in 1998, a comprehensive and longitudinal study of injury trends has not been performed. The purpose of this work is to report the epidemiology of injuries in MLB over that time utilizing disabled list (DL) data. Additionally, we sought to determine the financial impact of these injuries for MLB teams. During this analysis, we focused special attention on injuries of the medial ulnar collateral ligament (MUCL) and conducted a comprehensive review of all MUCL reconstructions ever performed on MLB players. Over the study period, there were a total of 8357 DL designations (mean of 464 annually). Players lost a total of 460,432 days (25,186 days annually) due to injury. Both the number of DL assignments and number of DL days increased from year to year (P < .001 and P = .003, respectively). Average length of DL assignments remained steady over time at 55.1 days (P = .647). Although shoulder injuries decreased (P = .023), this was met with a reciprocal increase in elbow injuries (P = .015). The average annual cost of designating players to the DL was $423,267,634 and a total of $7,618,817,407 was spent over the entire 18 seasons. Regarding MUCL injuries, a total of 400 MUCL reconstructions were performed in MLB players between 1974 and 2015, and the mean time to return to MLB competition was 17.1 months. The annual incidence of MUCL reconstructions increased dramatically from year to year (P < .001) and nearly one-third (n = 131, 32.8%) of all procedures performed over the 42-year period occurred in the last 5 years (2011 to 2015). In summary, overall injury rates and DL assignments continue to rise. Although shoulder injuries are declining, this improvement is countered by increasing elbow injuries, and these injuries continue to represent a significant source of lost revenue.

Emergency department surveillance of injuries and head injuries associated with baseball, football, soccer and ice hockey, children and youth, ages 5 to 18 years, 2004 to 2014.

TITRE: Surveillance aux services d'urgence des blessures à la tête et de l'ensemble des blessures provoquées par le baseball, le football, le soccer ou le hockey sur glace chez les enfants et les jeunes de 5 à 18 ans, 2004 à 2014.

Changes in physical size among major league baseball players and its attribution to elite offensive performance.

Major League Baseball (MLB) players have not been longitudinally examined for changes in physical size. Height, weight, and body mass indices (BMIs) were examined among offensive league leaders (OLL) and MLB reference cohorts at 1970, 1990, and 2010. Anthropometric values were expected to increase successively, where OLL were expected to be larger at each respective time point. A Mixed Model analysis of variance (p ≤ 0.05) examined anthropometric differences over time within and between groups. Mass and BMI increased over successive years with the largest effect seen between 1990 and 2010 (p < 0.001). A significant height reduction was shown for OLL from 1970 to 1990 (p ≤ 0.05), being the only significant decrease in physical size; yet, leaders were heavier and taller compared with the MLB reference population (p < 0.014). Results show that physical size has evolved in MLB, with the OLL being the largest players shown at each year in succession. Professional baseball scouts may have been influenced by greater offensive prowess shown by larger athletes; yet, increased secular anthropometrics must also be factored in greater heights, weights, BMIs shown over time in MLB. It is possible that greater participation in strength and conditioning programs at an earlier age, advances in sport nutrition, and potential abuse of anabolic drugs are factors perpetuating growth rates at present.

Secular trend: morphology and performance.

In a context of morphological expansion of the general population, how do athletes follow such a pattern of anthropometric growth? Is there any relation to performance? Biometric data including mass, height, body mass index (BMI) and age were collected for 50,376 American athletes representing 249,336 annual performers playing in professional baseball, football, ice hockey and basketball. Distributions by mass in National Football League (NFL) players are described by periods. Field goals have been studied in relation to players' height in the National Basketball Association (NBA). Between 1871 and 2011, athletes from the four sports have increased significantly in mass, height and BMI, following a multi-exponential function series. Consequently, biometric differences between athletes and the general population are increasing gradually. Changes in the mass distribution within the NFL show the emergence of a biometrical specificity in relation to the field position. At the professional level, performance remains structured around precise biometric values. In the NBA, a height-attractor at 201.3 ± 6.3 cm for the best scorers is invariant, regardless of the level of play. These results suggest that laws of growth and biometrics drive high-level sport and organise performance around the specific constraint of each field position. Discrepancies between some mass and height developments question the (disproportionate) large mass increase (relative to the height increase) during the 1980s and 1990s.

Fastball velocity trends in short-season minor league baseball.

Diminishing baseball velocities are objective measures to delineate pitching fatigue. Yet, velocity changes over the course of a competitive season vs. a single game remain unknown. This study examined fastball velocity (FBV) trends of minor league pitchers over an 8-game span. We assumed that accumulation of pitches would cause similar velocity decreases within games to produce velocity decreases between games pitched. Retrospective analysis of major league-affiliated pitching charts indicated mean FBVs, game pitches thrown, game innings pitched, rest days, and pitching work to rest ratios (PWRRs) for 12 pitchers over 8 games. Regression analyses (p < 0.05) were performed using the ordinary least squares method. The FBV was the dependent variable, where the explanatory variable was the game number (representing cumulative workload). Further analyses were performed on ball velocity differences predicted by days rest and PWRRs. The FBV increased linearly for the first 8 games of the season (R = 0.91, F(1,7) = 64.67, p < 0.001). Over the 8 - game period, mean FBVs increased 0.25 m/s (0.56 mph) with the greatest velocity increase occurring between the first and eighth game at 1.97 m/s (4.4 mph). Days rest and PWRRs did not impact FBV differences. When compared with previous research, minor league pitchers at the Class A Short Season level did not show similar exertion responses to cumulative workloads (pitches and innings pitched). Recovery factors (rest days, PWRRs, and training) also did not impact FBVs. Velocity increases may be attributable to biomechanical compensations, skill development, strength and conditioning regimens, multistarter rotations, and other performance-related factors. Strength and conditioning professionals should be aware of ball velocity trends, as apparent changes may infer neuromuscular fatigue and increased injury susceptibility, which require in-season training modifications.