Changes in Pitch Velocity and Selection in Major League Baseball Pitchers Following the Ulnar Collateral Ligament Reconstruction.

Background: The ulnar collateral ligament (UCL) is a soft-tissue stabilizer of the elbow, that is commonly injured among baseball pitchers due to excess valgus stress in overhead throwing motions. The location of a UCL tear typically ranges from the central aspect of the ligament to an avulsion-type injury at its proximal insertion site on the medial epicondyle of the humerus, or its distal insertion site on the ulna. The effect of UCL reconstruction on pitching performance has become a well-studied topic in medical literature. In our study, we aimed to identify general performance patterns amongst those having undergone UCL reconstruction surgery.

Methods: Data for patients with UCL reconstruction performed between 2010 and 2020 were extracted from publicly available databases. Pitching data was extracted from Brooks Baseball, a publicly available database for Major League Baseball (MLB) player statistics. We identified patients who played at least one full season after surgery and rehabilitation. Patient characteristics were evaluated for intergroup differences.

Results: Of 109 patients with UCL reconstruction, 87 were included in the final analysis. Compared to the preoperative group, the average postoperative fastball usage rate was less despite there being an increase in the off-speed usage rate. Velocity analysis demonstrated shifts of less than 1% for all three pitch groups compared to preoperative velocity average values (all P-values <0.05). Earned Run Average (ERA)+ demonstrates a decrease in the postoperative group; this finding was not significant (P=0.61).

Conclusions:  Patients treated surgically demonstrated a throwing tendency for their secondary and tertiary pitches and a decreased usage of fastballs. Further studies are needed to explore the factors contributing to the change in pitching performance.