Outcomes of isolated glenoid labral injuries in professional baseball pitchers

Background: Major League Baseball (MLB) pitchers who return to competition after labral surgery show a decline in their pitching performance. Design: Retrospective cohort. Setting: Tertiary institution. Patients: MLB starting or relief pitchers with isolated glenoid labral injuries. Interventions: Open or arthroscopic surgical repair of isolated glenoid labral injuries. Main Outcome Measurements: Individual statistics were reviewed for 42 MLB pitchers who underwent surgical repair of isolated glenoid labral injuries of their throwing shoulder between 1998 and 2003. Pertinent statistical data, including earned run average (ERA), innings pitched (IP), and walks plus hits per inning pitched (WHIP), were obtained for all players and compared before and after surgery. These statistics were evaluated for an association with demographic factors, pitching role, and rehabilitation time. Results: A total of 42 MLB pitchers (26 starters, 16 relievers) were included in the study with an average age of 27.5 years for starters and 29.9 years for relievers at injury time. There were 30 right-handed pitchers and 12 left-handed pitchers. In all, 69% of pitchers returned postoperatively to MLB for at least one season; 29% pitched for three seasons or more. For both relievers and starters, there was no statistically significant postoperative change in ERA or WHIP at I and 3 years. Starters had significantly decreased IP at I year, but not at 3 years. Relievers had no significant change in IP at I year postoperatively, but IP were significantly decreased at 3 years. Relievers missed less time after surgery than did starters (11.4 vs. 18.4 months). Conclusions: Most pitchers who were able to return to competition after surgery showed insignificant changes in ERA and WHIP and significant decreases in IP. Age, MLB experience, and pitching role as a reliever were the most significant factors related to a successful return after surgery.