Outcome of elbow surgery in professional baseball players.

We reviewed the records of 72 professional baseball players who underwent arthroscopic or open elbow surgery. The most common diagnoses were posteromedial olecranon osteophyte (65%), ulnar collateral ligament injury (25%), and ulnar neuritis (15%). Intraarticular loose bodies were found in 39% of the patients. Fifty-nine patients (82%) were observed 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 retired 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 patients who underwent ulnar collateral ligament reconstruction had a higher rate of return to play. The incidence of ulnar collateral ligament injuries was most likely underestimated in this group of athletes, with initial treatment directed at the secondary injuries instead of the primary ulnar collateral ligament injury.