Background:Thoracic outlet syndrome (TOS) remains a rare diagnosis but is being recognized as a cause of upper extremity dysfunction in professional baseball players.Purpose/Hypothesis:The purpose was to determine performance and return-to-play (RTP) outcomes in professional baseball players after surgical treatment of TOS. The hypothesis was that there would be a high RTP rate in professional baseball players after TOS surgery with no statistical differences in performance between pitchers who had TOS surgery and matched controls.Study Design:Cohort study; Level of evidence, 3.Methods:All professional baseball players who underwent surgical treatment of TOS between 2010 and 2017 were identified using the Major League Baseball Health and Injury Tracking System database. Demographic and performance data (before and after surgery) for each player were recorded. Performance variables were then compared between players who underwent TOS surgery and matched controls. The matching criteria were no history of previous surgeries on affected arm, age at time of surgery, throwing side, level of play (Major or Minor League Baseball), and years of experience playing professional baseball.Results:Overall, 52 players underwent surgery for TOS, of whom 46 (88%) were pitchers. The type of TOS was neurogenic in 69% and venous in 29%. One player had arterial TOS. After TOS surgery, 79% of players returned to play at the same or higher level (RTSP) by 9.5 months and played ≥3 years after surgery. No differences were found in RTSP rate based on the type of TOS. No statistical difference was found in RTP rates between major and minor league players. Pitchers had a 76% RTSP, which was similar to the natural attrition for control pitchers ( P = .874). After TOS surgery, pitchers saw a decline in several performance metrics, but these declines were not different from those of control pitchers, indicating that the decline in performance after TOS surgery was no faster than is seen in healthy professional pitchers as they age.Conclusion:The rate of RTSP after surgery for TOS in professional baseball players was 79%. There was no difference in RTP based on the type of TOS. Pitchers who underwent surgery for TOS had no significant differences in pitching performance metrics after surgery compared with matched controls.

中文翻译：

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职业棒球运动员胸廓出口综合征手术后的表现和恢复比赛：匹配队列分析


背景：胸廓出口综合征（TOS）仍然是一种罕见的诊断，但被认为是职业棒球运动员上肢功能障碍的一个原因。目的/假设：目的是确定职业棒球运动员的表现和重返比赛（RTP）结果TOS 手术治疗后的棒球运动员。假设职业棒球运动员在 TOS 手术后会有较高的 RTP 率，而接受 TOS 手术的投手和匹配对照之间的表现没有统计差异。证据级别，3。方法：使用美国职业棒球大联盟健康和伤害跟踪系统数据库识别 2010 年至 2017 年间接受 TOS 手术治疗的所有职业棒球运动员。记录每位球员的人口统计和表现数据（手术前和手术后）。然后对接受 TOS 手术的球员和匹配对照球员之间的表现变量进行比较。匹配标准是之前没有受影响手臂的手术史、手术时的年龄、投掷方、比赛水平（大联盟或小联盟棒球）以及打职业棒球的年数。结果：总共有 52 名球员接受了手术TOS，其中 46 名（88%）是投手。 TOS 类型为神经源性（69%），静脉性（29%）。一名球员有动脉 TOS。 TOS 手术后，79% 的球员在 9.5 个月内恢复到相同或更高级别 (RTSP) 的比赛，并在手术后参加比赛 ≥ 3 年。未发现基于 TOS 类型的 RTSP 速率存在差异。大联盟和小联盟球员之间的 RTP 率没有发现统计差异。投手的 RTSP 为 76%，与对照投手的自然损耗相似 (P = .874)。 TOS手术后，投手的几项表现指标有所下降，但这些下降与对照投手没有什么不同，这表明TOS手术后，随着年龄的增长，投手的表现下降并不比健康职业投手更快。结论：职业棒球运动员 TOS 手术后 RTSP 率为 79%。根据 TOS 类型，RTP 没有差异。接受 TOS 手术的投手与匹配的对照组相比，手术后的投球表现指标没有显着差异。