We reviewed the records of 72 professional baseball players who underw
ent arthroscopic or open elbow surgery. The most common diagnoses were
posteromedial olecranon osteophyte (65%), ulnar collateral ligament i
njury (25%), and ulnar neuritis (15%). Intraarticular loose bodies wer
e found in 39% of the patients. Fifty-nine patients (82%) were observe
d for a minimum of 24 months, with an average of 42 months' followup.
Forty-seven players (80%) returned to play for a minimum of one season
(73% at the same or higher level of play), and 17% of the players ret
ired initially because of their elbow injury. One third of the players
required two or more surgical procedures, with 25% of these patients
requiring an ulnar collateral ligament reconstruction after removal of
a posteromedial olecranon osteophyte. The patients with posteromedial
olecranon osteophytes had the highest rate of reoperation, and patien
ts who underwent ulnar collateral ligament reconstruction had a higher
rate of return to play. The incidence of ulnar collateral ligament in
juries was most likely underestimated in this group of athletes, with
initial treatment directed at the secondary injuries instead of the pr
imary ulnar collateral ligament injury.