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.
Exclusion criteria were non-MLB players, case series and case report studies with
a cohort of ≤3 players, and/or review articles.
Results
A total of 477 articles were identified from the initial search of 3 databases, with
105 studies meeting inclusion criteria. Among these articles, the most common injuries
studied were elbow (38%), shoulder (14%), hip/groin (11%), hand/wrist (7%), head/face
(7%), knee (7%), spine (5%), and foot/ankle (3%). Injuries with the greatest incidence
included hand/wrist (150.3 per year), hamstring (7.8-73.5 per year), ulnar collateral
ligament (UCL) tears (0.23-26.8 per year), gastrocnemius strains (24.2 per year),
and concussions (3.6-20.5 per year). Lowest rates of return to play were seen following
shoulder labral tears (40%-72.5%), rotator cuff tears (33.3%-87%), and UCL tears (51%-87.9%).
The injuries leading to most time away from sport included elbow UCL tears (average
90.3 days treated nonoperatively to 622.8 days following revision reconstruction),
shoulder labral tears (average 315-492 days), and anterior cruciate ligament (ACL)
tears (average 156.2-417.5 days). Following ACL tears, rotator cuff tears, shoulder
labral tears, and hip femoroacetabular impingement requiring arthroscopy, athletes
had a significantly lower workloads compared with before injury upon return to play.
Conclusions
Most published investigations focus on elbow injuries of the UCL, with variable return
to play and mixed performance following surgery. UCL tears, shoulder labral tears,
and ACL tears result in the most missed time. Upper-extremity injury such as shoulder
labral tears, rotator cuff tears, and UCL tears had the poorest return to play rates.
Workload was most affected following ACL reconstruction, rotator cuff repair, shoulder
labral repair, and hip arthroscopy for femoroacetabular impingement.
Level of Evidence
IV, systematic review of level II-IV studies.
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Article info
Publication history
Published online: December 28, 2022
Accepted:
December 13,
2022
Received:
June 7,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
The authors report the following potential conflicts of interest or sources of funding: M.T.F. reports board or committee member, American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine (AOSSM), American Shoulder and Elbow Surgeons, AANA, and International Society of Arthroscopy, Knee Surgery, and Orthopaedic Sports Medicine; research support from Major League Baseball; editorial or governing board, Medical Publishing Board of Trustees and AOSSM; research support from National Institute of Arthritis and Musculoskeletal and Skin Diseases, Eunice Kennedy Shriver National Institute of Child Health and Human Development, and Regeneration Technologies; IP royalties, paid consultant, paid presenter or speaker, and research support from Smith & Nephew; stock or stock options and unpaid consultant, Sparta; and paid consultant, Tornier. T.S.L. reports personal fees from Smith & Nephew, outside the submitted work; and board or committee member, American Orthopaedic Society for Sports Medicine. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Identification
Copyright
© 2022 by the Arthroscopy Association of North America
