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Orthop J Sports MedOrthop J Sports MedOJSspojsOrthopaedic Journal of Sports Medicine2325-9671SAGE Publications Sage CA: Los Angeles, CA 10.1177/2325967118S0014610.1177_2325967118S00146ArticlePerformance and Return to Sport Following Latissimus Dorsi and Teres
Major Injuries in Professional Baseball Pitchers Erickson Brandon J. MD1Chalmers Peter Nissen MD2D’Angelo John 3Ma Kevin 4Romeo Anthony A. MD51 Hospital for Special Surgery/Cornell
Medical Center Program, New York, NY, USA2 Washington University Medical Center, St
Louis, MO, USA3 Major League Baseball, New York, NY,
USA4 MLB, New York, NY, USA5 Midwest Orthopaedics at Rush, Chicago,
IL, USA27 7 2018 7 2018 6 7 suppl4 2018 AOSSM Annual Meeting Abstracts2325967118S00146© The Author(s) 20182018SAGE PublicationsThis open-access article is published and distributed under the
Creative Commons Attribution - NonCommercial - No Derivatives License
(http://creativecommons.org/licenses/by-nc-nd/4.0/), which
permits the noncommercial use, distribution, and reproduction of the article
in any medium, provided the original author and source are credited. You may
not alter, transform, or build upon this article without the permission of
the Author(s). For article reuse guidelines, please visit SAGE’s website at
http://www.sagepub.com/journals-permissions.Background:
Latissimus dorsi and teres major (LD/TM) tears are becoming an increasing
common cause of injury and disability amongst professional baseball
pitchers.

Purpose:
To determine the rate of return to sport (RTS) and performance upon RTS in
professional baseball pitchers following LD/TM tears treated both
operatively and non-operatively, and to see if there is a difference in RTS
rate and performance between players who sustained a LD/TM tear and matched
controls within each treatment group.

Hypothesis:
There is a high rate of RTS in professional baseball pitchers following LD/TM
tears with no significant difference in rate of RTS or performance,
specifically related to the primary outcome performance variables of earned
run average (ERA), WHIP ((walks +hits)/innings pitched), fielding
independent pitching (FIP), and wins above replacement (WAR)) between cases
and controls for both operative and non-operative treatment.

Methods:
All professional baseball pitchers who sustained a LD/TM tear between
2011-2016 were included. Demographic and performance data (pre and post
injury) for each player was recorded. Performance metrics were then compared
between cases and matched controls within both operatively non-operative
treatment.

Results:
Overall 120 pitchers sustained a LD/TM tear; 42 (35%) were playing at the
major league level at the time of injury. The majority of players (107
(89.2%)) were treated non-operatively. The average time to return to the
same level of competition for pitchers treated non-operatively was 170.7 +/-
169.7 days while for those treated operatively was 536.6 +/- 300.4 days. Of
the players treated with surgery, the mean time from injury to surgery was
97.5+/-115.5 days (range 12-453 days). The RTS rate among players treated
non-operatively and operatively was identical at 75%. Players treated
non-operatively had no change in ERA, FIP, or WAR following injury but had a
higher WHIP after injury (p=0.039). Players treated operatively had no
change in any measured performance metrics following surgery. No difference
existed between cases and controls in the primary performance variables

Conclusion:
LD/TM tears occur more frequently than previously reported. The majority of
LD/TM tears in professional baseball pitchers are treated non-operatively.
RTS rate for professional baseball pitchers following LD/TM tears treated
operatively or non-operatively is 75%. No significant difference in
performance was seen in these pitchers following tear/surgery compared to
matched controls.

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