Batter's Shoulder: Diagnosis, Management, and Outcomes.

Batter's shoulder is characterized by posterior shoulder instability in the lead (front) shoulder of a batting athlete. This most commonly occurs as a discrete event, particularly a swing and miss at an outside pitch, which leads to an episode of shoulder subluxation. A thorough history and physical examination is key to diagnosis, with patients feeling pain and instability of the lead shoulder when attempting the baseball swing or during pushing-type activities, as well as positive posterior labral signs in tests such as the Kim, jerk, and modified dynamic labral shear tests.

Upper-Extremity Injuries Have the Poorest Return to Play and Most Time Lost in Professional Baseball: A Systematic Review of Injuries in Major League Baseball.

Purpose: To summarize the incidence of injuries occurring in professional baseball and compare player outcomes reported in the literature.

Methods: We conducted a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines across 3 databases (PubMed, MEDLINE, Embase). Inclusion criteria were studies of injury incidences and/or injury outcomes on active Major League Baseball (MLB) athletes and studies published in the English language.

Athletes Perceive Weighted Baseballs to Carry a Notable Injury Risk, yet Still Use Them Frequently: A Multicenter Survey Study.

Introduction: Weighted baseball use in throwing programs is widespread; however, their use remains controversial. Prior research shows that weighted baseball programs can increase ball velocity but potentially increase throwing arm injuries. This study aims to ascertain perceptions of weighted baseballs among elite baseball players.

Editorial Commentary: Baseball Catchers Who Throw From a Squatted Position May Reduce Medial Elbow Torque by Stretching Exercise to Increase Passive Internal Rotation of the Throwing-Side Hip.

Youth baseball pitchers who also play catcher are at nearly 3-fold increased risk of developing a shoulder or elbow injury throughout the course of a season. The risk of injury has been largely attributed to the increased workload from a greater overall number of throws. In addition, throws performed by catchers are often performed in the squatting or kneeling position, which is radically different from all other positions.

Increased Accuracy in Templating for Total Knee Arthroplasty Using 3D Models Generated from Radiographs.

Templating prior to total hip arthroplasty is a widely adopted practice that aims to improve operative efficiency and reduce clinical outliers. Predicting implant size before total knee arthroplasty (TKA), although less common, could increase operating room efficiency by reducing necessary equipment needed for the procedure. This study compared templating accuracy in TKA using two-dimensional (2D) digital radiographs to a novel imaging technology that generates a three-dimensional (3D) model from these 2D radiographs.

Characterizing preoperative expectations for patients undergoing reverse total shoulder arthroplasty.

Background: There remains a paucity of information analyzing which factors most influence preoperative expectations for patients undergoing reverse total shoulder arthroplasty (RTSA). The purposes of our study were to characterize preoperative patient expectations for those scheduled to undergo RTSA and to determine the impact of demographic factors, shoulder function, and shoulder pain on these preoperative expectations.

Methods: Patients were prospectively recruited into the study if they were scheduled to undergo an elective unilateral primary RTSA for a diagnosis of glenohumeral arthritis.

The Effect of the Crow Hop on Elbow Stress During an Interval Throwing Program.

Background: Postoperative rehabilitation protocols after ulnar collateral ligament (UCL) reconstruction typically involve a structured interval throwing program. In an effort to minimize torque placed on the UCL, athletes are often instructed to throw with a crow hop, even at short throwing distances. However, the effect of the crow hop on medial elbow stress is unknown.

Using Wearable Technology to Evaluate the Kinetics and Kinematics of the Overhead Throwing Motion in Baseball Players.

Recent advancements in wearable technology have made kinetic and kinematic analysis of the throwing motion more accessible to recreational and professional baseball pitchers. Utilization of wearable technology to monitor the pitching motion has several potential applications for injury prevention and postinjury rehabilitation. However, the device must be properly applied to collect meaningful data.

What Are the Floor and Ceiling Effects of Patient-Reported Outcomes Measurement Information System Computer Adaptive Test Domains in Orthopaedic Patients? A Systematic Review.

Purpose: To perform a systematic review to answer the following: (1) What are the floor and ceiling (F/C) effects of the Patient-Reported Outcomes Measurement Information System (PROMIS) computer adaptive test (CAT) domains of physical function (PF), upper extremity physical function (UE), pain interference (PI), and depression (D) in adult orthopaedic patients? (2) Do the PROMIS-PF and PROMIS-PI domains have differing F/C effects depending on use in upper extremity, lower extremity, spine, neck, and back, or trauma patients?.

Methods: (Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines were followed, the review was registered on PROSPERO, and the methodological index for non-randomized studies was used for this systematic review. Studies reporting the F/C effects of at least 1 of 4 PROMIS CAT domains in orthopaedic patient cohorts accessed through PubMed and Embase on October 30, 2018, were included.

Fatigue Increases Dynamic Knee Valgus in Youth Athletes: Results From a Field-Based Drop-Jump Test.

Purpose: To determine whether fatigue increases dynamic knee valgus in adolescent athletes, as measured after a standardized exercise protocol and video-based drop-jump test. A secondary aim was to determine whether individual risk factors place certain athletes at increased risk for dynamic knee valgus.

Methods: Athletes aged 14 to 18 years were recruited for this video analysis study.

Importance of radar gun inclusion during return-to-throwing rehabilitation following ulnar collateral ligament reconstruction in baseball pitchers: a simulation study.

Background: Rehabilitation following elbow ulnar collateral ligament reconstruction in baseball pitchers relies on a progression of pitching activities to ensure protection and gradual strengthening of the reconstructed ligament. The purpose of this study was to determine the medial elbow torque associated with pitches at various effort levels and determine whether radar gun assistance improves players' abilities to accurately match partial-effort pitches with true references based on maximum pitch velocity.

Methods: Thirty-seven healthy high school and collegiate baseball pitchers were included in this study.

Predictors of elbow torque among professional baseball pitchers.

Background: Overuse injuries of the shoulder and elbow continue to be prevalent in elite baseball pitchers. Pitch velocity has been shown to impact medial elbow torque in adolescent baseball pitchers. However, the determinants of medial elbow torque in professional baseball pitchers are not known.

Relationship Between Glenohumeral Internal Rotation Deficit and Medial Elbow Torque in High School Baseball Pitchers.

Background: Alterations in throwing mechanics have been identified as a risk factor for overuse injuries in baseball players. Glenohumeral internal rotation deficit (GIRD) has been found to adversely affect throwing mechanics, but the effect of GIRD on medial elbow torque is unclear.

Purpose: To investigate the relationship between GIRD and medial elbow torque in high school-aged baseball pitchers.

Hamstring Injury Trends in Major and Minor League Baseball: Epidemiological Findings From the Major League Baseball Health and Injury Tracking System.

Background: Hamstring strains are the most common injury for professional baseball players and can result in significant time on the disabled list. To date, no study has reported the current trends in hamstring strains in professional baseball.

Hypothesis: Professional baseball players would have an increased incidence of hamstring strains from 2011 through 2016.

Using a Web-Based Data Collection Platform to Implement an Effective Electronic Patient-Reported Outcome Registry.

Modern health care places significant emphasis on patient-centered care. As a result, many orthopaedic providers are incorporating routine patient-reported outcome measure (PROM) collection into their practice. However, routine PROM collection often disrupts clinical workflow and can place a burden on both the patient and the provider.

Complete Rupture of the Triceps Tendon and Ulnar Collateral Ligament of the Elbow in a 13-Year-Old Football Player: A Case Report.

Introduction: With the increasing number of children and adolescents participating in sports, pathologies once reserved for high-level athletes are now emerging in this younger population. Distal triceps tendon tears represent an injury infrequently seen even among older, skeletally mature athletes. We report a case of distal triceps tendon tear with concomitant ulnar collateral ligament (UCL) injury in a skeletally-immature football player.

Feasibility of PROMIS CAT Administration in the Ambulatory Sports Medicine Clinic With Respect to Cost and Patient Compliance: A Single-Surgeon Experience.

Background: Pay-for-performance reimbursement models are becoming increasingly popular, but the implementation of a routine patient-reported outcome (PRO) collection system places additional burden on both the patient and the provider. The Patient-Reported Outcomes Measurement Information System (PROMIS) was developed in an effort to make PRO collection more practical and efficient, but providers may be reluctant to embrace a transition to a PROMIS-based clinical outcome registry.

Hypothesis: PROMIS can be successfully incorporated into daily clinical practice, with an overall patient compliance rate of 80%.

Adductor Canal Block Versus Femoral Nerve Block for Pain Control After Anterior Cruciate Ligament Reconstruction: A Prospective Randomized Trial.

Background: Femoral nerve block (FNB) is a commonly performed technique that has been proven to provide effective regional analgesia after anterior cruciate ligament (ACL) reconstruction. The adductor canal block (ACB) uses a similar sensory block around the knee while avoiding motor blockade of the quadriceps muscles.

Purpose/hypothesis: The purpose of our study was to compare the efficacy of FNB versus ACB for pain control after ACL reconstruction.

The Correlation Between PROMIS Pain Interference and VAS Pain in Ambulatory Orthopedic Patients.

The purpose of this study was to investigate the correlation of Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Interference (PI) score with traditionally collected visual analog scale (VAS) scores and to determine the influence of patient demographics on PROMIS PI and VAS scores. Patient demographics were collected, and PROMIS PI, PROMIS Physical Function (PF), and VAS questionnaires were distributed to 215 patients in orthopedic ambulatory clinics. The primary outcome was correlation between PROMIS PI and VAS questionnaires.

Effect of Fatigue on Medial Elbow Torque in Baseball Pitchers: A Simulated Game Analysis.

Background: The incidence of overuse injury to the elbow among baseball pitchers continues to rise, despite extensive efforts at pitch count regulations and emphasis on proper throwing mechanics.

Purpose: To determine if the medial elbow experiences increased torque levels as a baseball pitcher fatigues through the course of a simulated game.

Study Design: Descriptive laboratory study.

Predictors of Elbow Torque Among Youth and Adolescent Baseball Pitchers.

Background: There has been an increasing incidence of overuse elbow injuries among youth and adolescent pitchers. Pitch type has been implicated as a risk factor for excess torque at the medial elbow; however, this has not been definitively demonstrated.

Purpose: To assess predictors of torque across the medial elbow in youth and adolescent pitchers with a mobile sensor.

Performance, Return to Play, and Career Longevity After Ulnar Collateral Ligament Reconstruction in Professional Catchers.

Purpose: The purpose of our study was to evaluate return to play and postinjury performance of professional catchers who sustained an ulnar collateral ligament (UCL) rupture requiring surgical reconstruction. We looked to evaluate these players to determine the rate of return to play, the level of return to play, and career longevity after surgery as well as how statistical performance is affected by reconstruction.

Methods: Twenty-five professional catchers who underwent UCL reconstruction between 1985 and 2015 were identified and compared with an age-, position-, and competition-matched control group.

Assessment of Elbow Torque and Other Parameters During the Pitching Motion: Comparison of Fastball, Curveball, and Change-up.

Purpose: To assess the precision of a new wearable device in detecting medial elbow torque during the pitching motion in competitive baseball pitchers and to determine the differences in torque across pitch types and thrower demographic characteristics.

Methods: High school and collegiate baseball pitchers were recruited from August 1, 2016, to January 31, 2017, through direct request by athletic trainers and coaches. Body dimensions and throwing arm measurements of the participants were collected.