A study published last week in The American Journal of Sports Medicine examines the rate of return-to-sport, and subsequent performance and career length, in Major League Baseball (MLB) position players after ulnar collateral ligament (UCL) reconstruction or Tommy John surgery (TJS).
Most of the Tommy John data available is, as expected, about pitchers, but pitchers aren’t the only MLB players to undergo the procedure. So how do results for infielders (IFs), outfielders (OFs) and catchers compare?
Here’s a brief look at the data obtained by the team at Houston Methodist Orthopedic and Sports Medicine. The study looked at 33 players, between 26 and 34 years old, with a mean MLB experience of 6.3 yrs. (+- 3.9 yrs.):
How Many MLB Position Players Return-to-Sport After Tommy John Surgery?
Pitchers typically return to sport at a rate of 80% to 83%.
8% of the position players were able to return to the game. However, of the players that were 30 or older, only 53% returned.
Does Tommy John Surgery Impact Career Length in Position Players?
Short answer: Yes and no. It depends on the position.
Catchers in the study had significantly shorter career lengths after surgery than their matched controls. Their post-surgery careers were shorter by three seasons.
Players in other positions (IF/OF) did not have shorter careers after surgery than their control cases.
Is There an Improvement or a Decline in Performance after Tommy John Surgery?
Previous studies have observed both improvements and declines in pitchers after surgery, but the declines were not significantly different from control cases.
When comparing players to themselves before and after surgery, this study found that OFs had decreased Wins Above Replacement (WAR) after surgery. This was the only significant difference in any of the examined performance measures for players in any position.
Do Players Remain in Their Pre-Surgery Positions?
Again, it depends on the position.
100% of catchers stayed in their position after TJS.
45% of infielders and 42% of outfielders also remained in their pre-surgery positions.
33% of infielders and 25% of outfielders changed to positions that require less forceful throws over short distances (ie, OF to 1B/DH).
Since TJS is much more common in pitchers, there is very little medical literature focused on TJS in position players. This study provides a rare look at the available data.
Stealing Third Base Wins a Sprained Thumb
The New York Daily News of April 29, 2018 reported that earlier in the day, New York Mets’ outfielder Yoenis Cespedes successfully stole two bases in one inning. But he had to sit out the third inning of the team’s victory game over the San Diego Padres. In his headlong dive into third base, Cespedes’ left thumb collided with the base.
An initial x-ray showed no damage; a follow-up exam set for the next day may reveal a type of injury common to skiers – gamekeeper’s thumb. This occurs when the thumb is forcefully pulled away from the index finger.
Depending on the force of the movement, one or more tears can occur in the ulnar collateral ligament (UCL), which supports the metacarpophalangeal joint, located where the thumb meets the hand. The UCL is on the top of the joint; its opposite is the radial collateral ligament (RCL). Tears of the RCL are rare, but possible. Gamekeeper’s thumb is more likely to occur in those who smoke, have arthritis, or repetitive strain injuries.
According to the American Society for Surgery of the Hand, symptoms of a sprained thumb include swelling of the joint, bruising, pain, weakness, difficulty writing, and a decreased ability to hold objects (like a glass) or manipulate objects (like turning a doorknob). Depending on the severity of the sprain, treatment options range from splinting to surgery. Early evaluation and treatment can contribute to a full recovery from a sprain.
Cespedes has had similar injuries in the past and is anticipating a brief hiatus – 3 days – before he’s back in the game. Injuries like his are common but shouldn’t be taken lightly; delay can mean ongoing weakness long after the sprain is healed. The surgeons at Hand and Wrist Institute can thoroughly evaluate thumb injuries and create an optimal plan of action to restore function. For more information, contact us.