ArticleOrthopaedic journal of sports medicine2026
Return to Play and Performance After Revision Ulnar Collateral Ligament Reconstruction in Major League Baseball Pitchers.
Article in Orthopaedic journal of sports medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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9 authors.
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Abstract
Background: While return to performance has been characterized after primary ulnar collateral ligament (UCL) surgery, it has not been well defined after revision UCL reconstruction (rUCLR), particularly in Major League Baseball (MLB) pitchers. Purpose: To evaluate return to performance in MLB pitchers after rUCLR. Study Design: Descriptive epidemiology study. Methods: Return-to-play (RTP) analysis was conducted on 61 MLB pitchers who underwent rUCLR from January 2014 to November 2024 and compared to the results of 129 MLB pitchers who underwent primary UCL surgery during the 2018 to 2023 seasons, when pitch-tracking metrics became widely available and were used in a previous study. Return-to-performance analysis was then conducted according to inclusion criteria on 20 MLB pitchers who underwent rUCLR compared to 40 uninjured controls and 54 pitchers who underwent primary UCL surgery. Paired and unpaired Results: The mean age was 28.00 ± 4.16 years. After rUCLR, 1.6% returned to play at 1 year, 44.1% at 2 years, and 63.2% at 3 years postoperatively, with a mean of 605 ± 163 days. Revision UCLR resulted in significantly reduced RTP rates at 2 years ( Conclusion: Only 63% of MLB pitchers returned to play after rUCLR, and a majority did not return to full performance, defined as returning to 5 key preoperative metrics (expected fielding-independent pitching, fWAR, velocity, fastball velocity, and spin rate). These data suggest that after rUCLR, MLB pitchers RTP at lower rates and typically at decreased performance compared to pre-revision levels and after primary UCL surgery.
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