Despite heightened awareness and injury prevention measures, the rate of overuse injuries to the shoulder and elbow in baseball players continues to rise to epidemic proportions. Recent literature indicates that rates of ulnar collateral reconstruction are increasing among the sport’s highest tier of players and among recreational players alike. Moreover, adolescent baseball players are continuing to throw with pain, even in the setting of increased regulations toward pitch counts and pitch types in this population.

Once these players are injured, the goal of treatment is to restore their ability to compete at the preinjury level. However, return to play is just one of many outcome metrics that are available for measurement, because a variety of objective measures (ie, range of motion, strength, stability) and subjective measures (satisfaction scores and patient-reported outcome

[PRO] measures) exist. For professional athletes, advanced performance metrics have also become increasingly utilized. Examples of such metrics include earned run average (ERA), batting average against, walks plus hits per inning pitched, and several others that are routinely collected during pitching performances of (typically) collegiate and professional players. Unfortunately, an excess of outcome reporting options may also lead to confusion when trying to compare the results of clinical studies of a given intervention that report 2 different outcome scores. Moreover, given the high level of performance and demands placed on these players’ upper extremities, traditional reporting scores (eg, the Disabilities of the Arm, Shoulder and Hand [DASH] or Short Form scores) may exhibit a prohibitive ‘‘ceiling effect,’’ forcing clinicians to incorporate less widely used scores. Prior studies of patients undergoing anterior cruciate ligament (ACL) reconstruction have demonstrated that, despite all having a common diagnosis, significant variability in outcome reporting patterns exists, rendering comparisons across different studies challenging.

The goal of this study was to identify the variability in reporting of outcomes among studies of shoulder and elbow injuries in baseball players. We hypothesized that there will be significant variability in reporting of outcomes across studies. Moreover, we hypothesized that time to return to preinjury level of play and satisfaction scores will be underreported in the literature.

Full Article: Outcomes Following Shoulder and Elbow Injury in Baseball Players: Are we Reporting What Matters?