(Press-News.org) VIDEO:
Vasilios (Bill) Moutzouros, M.D., a Henry Ford Hospital orthopedic surgeon and study's senior author explains that pitchers do not regain performance after Tommy John surgery.
Click here for more information.
DETROIT – Major League Baseball players who undergo Tommy John surgery are less likely to regain the performance level they had before surgery, according to a Henry Ford Hospital study.
The study is the first to show a link between the surgery and declining pitching performance at the professional level. It also involved the largest cohort of professional pitchers to date to examine the issue.
Researchers analyzed pitching statistics of 168 MLB pitchers before and after surgery between 1982 and 2010 and found diminishing returns in three major pitching categories: Earned runs average (ERA), walks and hits per inning pitched (WHIP) and innings pitched (IP). The findings:
ERA increased 4.15 to 4.74.
WHIP increased 1.40 to 1.48.
IP declined 59 to 50.
"Tommy John surgery is an effective surgery and most pitchers get back to pitching after surgery. But it's not going to improve their level of performance," says Vasilios (Bill) Moutzouros, M.D., a Henry Ford orthopedic surgeon and the study's senior author.
"There's been a perception that the surgery will make you better. Our findings debunk that perception. Eighty to 90 percent of major league pitchers will get back to pitching at the major league level but they just won't be as effective as they were before injury."
The study is being presented at the annual meeting of the American Academy of Orthopedic Surgeons March 11-15 in New Orleans.
Tommy John surgery, named after the former Los Angeles Dodgers pitcher who underwent the pioneering surgery 40 years ago, has been since performed on legions of pitchers at the professional and collegiate levels. In medicine it is known as ulnar collateral ligament (UCL) reconstruction. During the two-hour outpatient procedure, the ulnar collateral ligament in the medial elbow is replaced with a tendon from the same arm or from the hamstring area.
Until Henry Ford's observational study, other research had shown that a high percentage of players returned to the same level of performance after UCL reconstruction, and the perception among players, coaches and parents was that UCL reconstruction would even lead to a higher level of performance. In the only other study involving just MLB pitchers (68 pitchers), 82 percent of them returned to the mound after surgery and had no significant decline in performance.
Henry Ford researchers sought to examine the effects of UCL reconstruction on pitching performance involving the largest cohort of MLB pitchers and identify risk factors associated with the pitching injury, says Robert Keller, M.D., a third-year Henry Ford orthopedic resident and study co-author whose father Phil was a teammate of Tommy John in the 1970s.
The cohort of 168 pitchers pitched in at least major league game after undergoing UCL reconstruction between 1982 and 2010. Data collected included the year of surgery, pitchers' age, years of MLB experience, height/weight, body mass index, pitching arm injured, pitching role, pitching statistics, and whether the pitcher returned to MLB pitching after surgery. This was then averaged for the three years of pitching before UCL reconstruction and for the three years after returning to play.
For comparison, researchers collected similar data of 178 MLB pitchers in a control group with no prior UCL reconstruction and age-matched them with a corresponding UCL reconstruction pitcher. Performance was determined using three years of statistics before their "index year" (their roster year of either 2004 or 2005) and three years after their "index year."
Drs. Moutzouros and Keller used paired analysis, generalized estimating equation model and other commonly used research tests to evaluate the data. Other highlights:
UCL pitchers were "statistically better" than the control group in ERA, WHIP, IP and win percentage in the three years and two years before surgery.
In the year before surgery, UCL pitchers' performance declined significantly.
After surgery, the control group was either superior in nearly every performance measure or no difference observed.
A predictor of surgery is MLB experience. Sixty percent of pitchers required UCL reconstruction within their first five years in the MLB.
While the cause of UCL injury is not fully known, orthopedic specialists theorize it's due to overuse and stress on the elbow, pitching velocity and joint motion, Dr. Keller says, adding that surgery isn't a panacea.
"We even have parents who come into our clinic asking if their children can have the surgery even before they injure anything because they think potentially it can make them better. What this study shows is it doesn't. Matter of fact, players get statistically worse after having this surgery."
INFORMATION:
Study: MLB pitchers don't regain performance level after Tommy John surgery
2014-03-11
[Attachments] See images for this press release:
ELSE PRESS RELEASES FROM THIS DATE:
Patients with metabolic disorder may face higher complication risk following total joint replacement
2014-03-11
NEW ORLEANS─In a new study presented today at the 2014 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS), researchers found that total joint replacement patients with three or more metabolic syndrome risk factors were almost three times as likely to have complications within the first year after joint replacement.
Metabolic syndrome is a combination of disorders, such as obesity with a body mass index (BMI) ≥30kg/m², dyslipidemia (an abnormal amount of lipids in the blood), hypertension and diabetes. An estimated 47 million adults, ages ...
Study finds no greater injury risk on artificial playing surfaces
2014-03-11
NEW ORLEANS─New research presented today at the 2014 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS) found no greater injury risk for athletes playing on artificial playing surfaces.
The use of artificial playing surfaces at sport venues has increased significantly in recent years, primarily due to the advantages of artificial turf over natural grass: longer playing hours, lower maintenance costs and greater resilience to harsh weather conditions. Despite these advantages, many elite professional soccer teams are reluctant to install artificial ...
Major League Baseball players win more games following Tommy John surgery
2014-03-11
NEW ORLEANS─Ulnar collateral ligament (UCLR) reconstruction, otherwise known as "Tommy John Surgery," is a procedure frequently performed on Major League Baseball (MLB) pitchers with a damaged or torn ulnar collateral ligament, a common elbow injury, typically from overuse.
In the new study, "Rate of Return to Pitching and Performance after Tommy John Surgery in Major League Baseball Pitchers," * presented today at the 2014 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS), researchers looked at the rate of return to MLB pitching following UCLR, ...
Total hip replacement surgery safe for nonagenarian patients
2014-03-11
NEW ORLEANS--As more Americans are living well into their 90s, the number of nonagenarian total hip replacement (THR) candidates continues to increase. In the study, "Total Hip Arthroplasty Proves Safe for Nonagenarian Patients," presented today at the at the 2014 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS), researchers reviewed patient characteristics and rates of postoperative morbidity, mortality and readmission among patients who underwent elective THR surgery between April 2001 and December 2011.
Of the 43,543 THRs performed during this ...
Genetics may explain high-functioning senior athletes with hip abnormalities
2014-03-11
NEW ORLEANS─Genetics may explain why some senior athletes are high functioning despite having one or both hip abnormalities typically associated with early onset osteoarthritis (OA): developmental dislocation of the hip (dysplasia), a loose hip joint; or femoroacetabular impingement (FAI), a condition in which the hip bones are abnormally shaped, according to new research presented today at the 2014 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS).
In the study, "Prevalence of Radiographic Abnormalities in Senior Athletes with Well-functioning ...
Clinical trial identifies women most likely to benefit from vaginal mesh surgery
2014-03-11
Certain women with vaginal prolapse are most likely to benefit from undergoing vaginal mesh surgery, a technique that has become controversial and is the focus of numerous lawsuits. The findings, which are published early online in Ultrasound in Obstetrics & Gynecology, provide valuable information regarding who should and should not be considered candidates for the surgery.
Vaginal prolapse—when pelvic tissues weaken and the vaginal canal may protrude through the vaginal opening—affects roughly 10% to 20% of women. A significant number of patients require repeat surgeries ...
Healthy food is good for you -- and can sell, too
2014-03-11
In the fall of 2008, the booster club in Muscatine, Iowa took a chance. Researchers from the University of Iowa asked whether the club would add healthy foods – from apples to string cheese – to its concessions menu. And, by the way, would it also consider putting healthier ingredients in big sellers like nachos and popcorn?
These were no idle requests. Booster clubs across the United States directly support schools' athletic and extra-curricular programs like band and choir. The Muskie Boosters, for instance, raise $90,000 annually for athletics and other outside school ...
Light pollution impairs rainforest regeneration
2014-03-11
These new findings were reported by scientists from the German Leibniz Institute for Zoo and Wildlife Research Berlin (IZW). The study – published in the British Ecological Society's Journal of Applied Ecology – is the first to show that seed-dispersing bats avoid feeding in light-polluted areas.
Working in Costa Rica with Sowell's short-tailed bats (Carollia sowelli), Daniel Lewanzik from the IZW gave the bats a simple choice. He divided a flight cage into two compartments. One was naturally dark and the other was illuminated by a sodium street lamp, the most common ...
Glucosamine fails to prevent deterioration of knee cartilage, decrease pain
2014-03-11
A short-term study found that oral glucosamine supplementation is not associated with a lessening of knee cartilage deterioration among individuals with chronic knee pain. Findings published in Arthritis & Rheumatology, a journal of the American College of Rheumatology (ACR) journal, indicate that glucosamine does not decrease pain or improve knee bone marrow lesions—more commonly known as bone bruises and thought to be a source of pain in those with osteoarthritis (OA).
According to the ACR 27 million Americans over 25 years of age are diagnosed with OA—the most common ...
Speed trap for fish catches domestic trout moving too slow
2014-03-11
PULLMAN, Wash.—Washington State University researchers have documented dramatic differences in the swimming ability of domesticated trout and their wilder relatives. The study calls into question the ability of hatcheries to mitigate more than a century of disturbances to wild fish populations.
Kristy Bellinger, who did the study for her work on a Ph.D. in zoology, said traditional hatcheries commonly breed for large fish at the cost of the speed they need to escape predators in the wild.
"The use of hatcheries to support declining wild salmon and steelhead is controversial," ...