LAUSR

INTRODUCTION Medial ulnar collateral ligament (UCL) injuries and posterior elbow impingement commonly effect throwing athletes. Surgical intervention for each of these pathologies individually has been demonstrated to be successful with high return to play rates. Our purpose is to report return to play rates for patients treated by our senior author with concurrent UCL reconstruction and arthroscopic posterior débridement. MATERIALS/METHODS We retrospectively reviewed all elbow medial ulnar collateral ligament procedures performed by the senior author from January 2016 through September 2020. Inclusion criteria included elbow medial ulnar collateral ligament operation with an arthroscopic posterior compartment débridement in a throwing athlete. Exclusion criteria included isolated UCL reconstruction surgery, non-primary surgery, and revision UCL reconstruction with either autograft or allograft. Utilizing chart review and publicly available information we were able to determine patients playing level after their operation. RESULTS 12 patients met inclusion and exclusion criteria. The average age was 24.27 years old (SD = 4.92). Of the 12 patients, 10 of them returned to play at the same level (4 MLB players, 1 Triple A player) or higher (2 players from Single A to Double A, 1 player from NCAA Division I to Single A, 1 player from Rookie League to Single A, and 1 player from High School to NCAA Division I), 1 did not return to play and 1 returned to play at a lower level, with an average return-to-play (RTP) time of 14.64 months (SD = 2.64 months). Of the 12 patients, 11 of them were pitchers and of the 11 pitchers, 9 of them had stats both before and after their UCL reconstruction. Before their UCL reconstructions, the average stats for the pitchers were ERA of 4.11±0.85, WHIP of 1.42±0.26, K/BB of 3.00±1.83, K/9 of 8.80±1.14, and 234.88±316.74 innings pitched. After their UCL reconstructions, their average stats were ERA of 5.24±2.18 (p=0.189), WHIP of 1.55±0.34 (p=0.379), K/BB of 2.15±0.98 (p=0.263), K/9 of 9.67±1.91 (p=0.293), and 138.71±162.97 (p=0.487) innings pitched. DISCUSSION/CONCLUSION While surgical intervention to address both posterior impingement and UCL injury is relatively rare (8.5% of all the senior author's UCL reconstructions), our experience demonstrates primary UCL reconstruction with concurrent arthroscopic posterior decompression is a reliable, safe, and successful surgical treatment for patients with UCL injury and posterior impingement and our results show no significant difference in statistical performance in pitchers from before and after their surgery.