Return to sport and performance outcomes after isolated Bankart repair in professional baseball players

Abstract

Background: To report the return to sport (RTS) rate, time until RTS, and performance outcomes in professional baseball pitchers and position players who underwent isolated Bankart repair.

Methods: The Major League Baseball Health and Injury Tracking System database was queried for all major league and minor league baseball players who underwent isolated Bankart repair from 2011 to 2022. Outcomes of interest included RTS rate, time until RTS, and performance outcomes. Performance outcomes for pitchers include earned run average and walks + hits per inning pitched, and for position players included batting average (AVG), on-base percentage, slugging percentage, and on-base plus slugging percentage. Performance statistics were evaluated every season-year from 3 seasons before to 3 seasons after surgery.

Results: Overall, 111 professional baseball players comprised of 47 pitchers and 64 position players were included with 86 (77.5%) players at the Minor League Baseball level and a mean age of 23 ± 4 years. All injuries in pitchers were noncontact/overuse, while injuries in position players were more frequently (62.5%) due to contact. Most pitchers (91%) and 47% of position players underwent repair of the throwing shoulder. Pitchers were able to RTS at a lower rate than position players (72.3% vs. 95.3%, P = .002) and took longer to RTS than position players (334 days vs. 245 days, P < .001). Position players who underwent repair of the throwing shoulder returned to sport 101 days later (301 days vs. 200 days, P < .001) than position players who underwent repair of the nonthrowing shoulder. No significant changes in pitching rate statistics (earned run average, walks + hits per inning pitched, and AVG) or position player offensive rate statistics (AVG, on-base percentage, slugging percentage, and on-base plus slugging percentage) were observed throughout the study timeline (all P > .05).

Conclusion: Pitchers injure their anterior labrum due to overuse while the majority of position players injure their anterior labrum due to contact. Professional baseball pitchers RTS less frequently and take longer to RTS than position players following Bankart repair. Repair of the throwing shoulder can delay RTS by an additional 100 days compared to repair of the nonthrowing shoulder for position players.

Keywords: Bankart; Baseball; MLB; labrum; pitcher; return to sport; shoulder.