Management of ulnar collateral ligament injury in baseball athletes: An online survey in Japanese surgeons

Shota Hoshika; Kazunari Tomita; Keisuke Matsuki; Hiroshi Kusano; Jun Yamakawa; Shogo Yonekawa

doi:10.1016/j.jos.2024.03.001

Management of ulnar collateral ligament injury in baseball athletes: An online survey in Japanese surgeons

J Orthop Sci. 2024 Mar 12:S0949-2658(24)00046-0. doi: 10.1016/j.jos.2024.03.001. Online ahead of print.

Authors

Shota Hoshika¹, Kazunari Tomita², Keisuke Matsuki³, Hiroshi Kusano⁴, Jun Yamakawa⁵, Shogo Yonekawa⁶

Affiliations

¹ Shoulder & Elbow Service, Funabashi Orthopaedic Sports Medicine & Joint Center, Funabashi, Chiba, Japan. Electronic address: shoshika@fff.or.jp.
² Faculty of Human Development, Department of Health and Physical Education, Kokugakuin University, Tokyo, Japan.
³ Shoulder & Elbow Service, Funabashi Orthopaedic Sports Medicine & Joint Center, Funabashi, Chiba, Japan.
⁴ Sports Medical Center, Keiyu Orthopaedic Hospital, Gunma, Japan.
⁵ Kanazawa Hakkei Orthopaeic Clinic, Kanagawa, Japan.
⁶ Setagaya Okusawa Orthopaedic Hospital, Tokyo, Japan.

PMID: 38480072
DOI: 10.1016/j.jos.2024.03.001

Abstract

Background: The management of ulnar collateral ligament (UCL) injuries widely varies among surgeons. Although various treatment options have been proposed including surgical and conservative treatments, no golden standard treatment strategy has been established of yet. The American survey reported an overall experienced and well-trained cohort of surgeons often reached consensus opinions on how to approach UCL injury. However, the consensus among Japanese surgeons on the treatment of UCL injuries remains unclear. The purpose of this study was to survey current trends among Japanese orthopaedic surgeons in the treatment of UCL injuries in baseball players.

Methods: An online survey was distributed to the active members of the Japanese doctor's network for baseball injury prevention, which was formed by partial members of the medical committee in the Japan Baseball Council. The survey was composed of three sections: demographics of the surveyees, preferred operative and nonoperative management of UCL injuries, and five fictional clinical case scenarios of baseball players with a UCL injury.

Results: The 131 e-mailed invitations to society members yielded 78 completed online surveys with a participation rate of 60%. Sixty-four respondents (82%) reported >15 years of clinical experience. Sixty-five respondents (83%) performed ≤5 UCL reconstructions per year. As nonsurgical management of UCL injuries, seventy-four surgeons (95%) preferred physiotherapy followed by intraarticular injection (46%). For surgical management, seventy-three surgeons (93%) preferred UCL reconstruction. Of the five case scenarios, a consensus was reached in three cases: to perform surgery on the patient with full-thickness UCL tear. When operative management was the preferred option, a consensus was reached to perform UCL reconstruction.

Conclusion: Japanese doctors involved in the treatment of baseball injuries reached a consensus to indicate high-level athletes with a full-thickness UCL tear for surgery. When operative management was the preferred option, a consensus was reached to perform UCL reconstruction. These results may contribute to the decision-making for managing UCL injuries.

Keywords: Nonoperative management; Ulnar collateral ligament injury; Ulnar collateral ligament reconstruction.