Document Detail


Does posteromedial chondromalacia reduce rate of return to play after ulnar collateral ligament reconstruction?
MedLine Citation:
PMID:  22009711     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Biomechanical studies suggest ulnohumeral chondral and ligamentous overload (UCLO) explains the development of posteromedial chondromalacia (PMC) in throwing athletes with ulnar collateral ligament (UCL) insufficiency. UCL reconstruction reportedly allows 90% of baseball players to return to prior or a higher level of play; however, players with concomitant posteromedial chondromalacia may experience lower rates of return to play.
QUESTIONS/PURPOSES: The purpose of this investigation is to determine: (1) the rates of return to play of baseball players undergoing UCL reconstruction and posteromedial chondromalacia; and (2) the complications occurring after UCL reconstruction in the setting of posteromedial chondromalacia.
METHODS: We retrospectively reviewed 29 of 161 (18%) baseball players who were treated for the combined posteromedial chondromalacia and UCL injury. UCL reconstruction was accomplished with the docking technique, and the PMC was addressed with nothing or débridement if Grade 2 or 3 and with débridement or microfracture if Grade 4. The mean age was 19.6 years (range, 16-23 years). Most players were college athletes (76%) and pitchers (93%). We used a modified four-level scale of Conway et al. to assess return to play with 1 being the highest level (return to preinjury level of competition or performance for at least one season after UCL reconstruction). The minimum followup was 24 months (mean, 37 months; range, 24-52 months).
RESULTS: Return to play was Level 1 in 22 patients (76%), Level 2 in four patients (14%), Level 3 in two patients (7%), and Level 4 in one (3%) patient.
CONCLUSIONS: Our data suggest baseball players with concomitant PMC, may have lower rates of return to the same or a higher level of play compared with historical controls.
LEVEL OF EVIDENCE: Level IV, case series. See Guidelines for Authors for a complete description of levels of evidence.
Authors:
Daryl C Osbahr; Joshua S Dines; Andrew J Rosenbaum; Joseph T Nguyen; David W Altchek
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  470     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-05-09     Completed Date:  2012-08-20     Revised Date:  2013-06-27    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1558-64     Citation Subset:  AIM; IM    
Affiliation:
Hospital for Special Surgery, New York, NY, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Arthroplasty, Subchondral
Arthroscopy
Baseball / injuries*
Cartilage Diseases / complications*,  diagnosis,  surgery
Cartilage, Articular / pathology,  surgery
Collateral Ligaments / injuries*,  pathology,  surgery*
Cumulative Trauma Disorders / diagnosis,  surgery*
Debridement
Elbow Joint / surgery*
Humans
Magnetic Resonance Imaging
Reconstructive Surgical Procedures / methods
Young Adult
Grant Support
ID/Acronym/Agency:
UL1-RR024996/RR/NCRR NIH HHS
Comments/Corrections

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