Okay. Good afternoon, all. My name is Sam Rao. I'm a previous research fellow from Rothman Orthopedics and current intern at Westchester Medical. I just want to thank all of you for being here today and allowing me to share some of my research with you guys. I'll be presenting on Return to Play Rates in Adolescent Baseball Players After Slap Repair. These are my co-authors. I have no relevant financial disclosures. So slap tears, otherwise known as superior labrum from anterior to posterior tears, are common in the overhead throwing athlete. This injury is usually secondary to the repetitive throwing motion that these athletes perform and the resulting strain on the shoulder and more specifically the biceps tendon and its attachment to the superior labrum. So in the recent decade, numerous studies have shown a dramatic increase in adolescent overhead throwing sports-related shoulder and elbow injuries. There are a number of influencing factors. However, the two most important probably are early sports specialization and an overall increase in adolescent sports participation overall. Numerous other studies have shown, have demonstrated outcomes for slap repair in overhead athletes as well. Gilliam in 2017 demonstrated that 62% of their specifically baseball players were able to return to play. And Sadie in 2012 in their systematic review similarly demonstrated that 63% of their overhead athletes were able to return to play. That being said, there's not a whole lot of data on adolescent outcomes after slap repair for baseball athletes. So the purpose of our project was to determine in-adolescent baseball players following slap repair, patient-reported outcomes, patient satisfaction, long-term progression of play and natural history for the injury. We hypothesized that this young cohort would experience high post-operative PROs, excellent patient satisfaction and progress to higher levels of play and overall have a high return to play rate. So methods, we included baseball athletes between the ages of 10 to 19 over a 10-year period. These were isolated slap repairs without any other major shoulder pathology. And the surveys we administered are there below. So the cohort, 59 patients met the inclusion criteria. 45 were eventually available for follow-up. These were all male baseball athletes with a mean age of 15.8. 17 were pitchers, 28 were position players. 31 were either in high school or middle school and 14 were in college. And the mean follow-up for the cohort was about 5.3 years. So going to the meat of the results, the return to play rate for our cohort was 75.6%. And with seven of these players having to switch positions in order to return to play. Breaking it down, 71% of high school and middle school players were able to return to play as compared to the 85% of college players who were able to return to play. And notably, we did not find any difference in return to play rates between pitchers and position players. Moreover, time to return to throwing was about six months and time to return to play was about 11.3 months. So moving on to progression of play, in our cohort we found that 12 players were able to eventually progress to the next level. In our cohort, all 12 of these players went from high school to college. And unfortunately, none of the college players were eventually able to reach the professional status. The mean competitive postoperative career length for these players in our cohort were about three years. And at final follow-up, 32 players reported that they had stopped playing baseball for various reasons. About a third because they had not been recruited to the next level, a third because they lost the desire to play, and a third specifically cited the shoulder as the reason that they did not return to play. So PROs and performance. Overall, our cohort had a KJOC score of 60, pretty poor. But notably, we also found no difference in PROs between pitchers and position players. However, subjectively speaking on self-assessment, pitchers reported that they did return to play significantly worse than their position player counterparts. And then moving on, finally, to satisfaction. Overall, the satisfaction for the cohort was 83.2%. 39 players reported that given the opportunity, they would undergo the surgery again. This cohort had no major postoperative complications. However, there were a number of postoperative injuries. Three reported having revision labral surgery. Two, a shoulder dislocation in the ipsilateral arm. And then one had a rotator cuff injury. So limitations. I mean, this is a retrospective study, therefore subject to recall bias and selection bias. And while this was a large sample size for this patient population, it's still a small sample size to make any definitive conclusions. And perhaps most importantly, we lacked performance metrics, both preoperatively and postoperatively, meaning we weren't able to really determine an accurate return to prior performance. Nonetheless, in conclusion, we conclude that PROs are similar to what's been reported in the literature for other populations who've undergone slap repairs. The return to play rate in our cohort was a little bit higher than in older populations than in the previous literature. There's relatively high satisfaction rates for this cohort. And at least for high school players, they were able to progress to the next level of play at a moderate rate. Thank you.

Return to Play Rates

Adolescent Baseball Players

Slap Repair

Shoulder and Elbow Injuries

Early Sports Specialization