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Park, Yoon, Oh, Yoo, Bang, and Kang: Arthroscopic Olecranon Osteophyte Resection in the Baseball Players with Elbow Valgus Extension Overload Syndrome
Clinical Article

Korean J Sports Med 2013;31(2):45-50.

Published online: 10 January 2013

DOI: https://doi.org/10.5763/kjsm.2013.31.2.45

Arthroscopic Olecranon Osteophyte Resection in the Baseball Players with Elbow Valgus Extension Overload Syndrome

Jin-Young Park1, Hyung-Moon Yoon2, , Kyung-Soo Oh1, Hyun-Yul Yoo1, Jin-Young Bang1, Daemyung Kang2

1 Glocal Center for Shoulder and Elbow, Department of Orthopedic Surgery, Konkuk University School of Medicine, Seoul

2 Department of Orthopaedic Surgery, Konkuk University Chungju Hospital, Konkuk University School of Medicine, Chungju, Korea

Correspondence: Hyung-Moon Yoon Department of Orthopaedic Surgery, Konkuk University Chungju Hospital, Konkuk University School of Medicine, 82 Gugwon-daero, Chungju 380-704, Korea Tel: +82-43-840-8250, Fax: +82-43-840-3377, E-mail: iulius00@naver.com

Received 10 January 2013       Revised 17 November 2013       Accepted 18 November 2013

Copyright © 2013 The Korean Society of Sports Medicine

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

We evaluated the clinical outcome after arthroscopic olecranon osteophyte resection without ligament operation in the elite baseball players who had valgus extension overload syndrome without moderate or severe medial collateral ligament injury. From January 2007 to December 2011, twelve patients underwent arthroscopic osteophyte resection without ligament operation and they were followed for more than 12 months. The mean age was 19.2 years and mean follow-up period was 26 months. The clinical results were evaluated using range of motion, visual analogue scale (VAS) and Mayo elbow performance score (MEPS). After checking osteophyte size and location through 3-dimensional computed tomography, arthroscopic osteophyte resection was performed. Average preoperative extension, flexion, pronation and supination were 2.3 o, 138.2 o, 76.4 o, and 69.1 o. Average postoperative extension, flexion, pronation and supination had been changed into 0.7 o, 137.3 o, 79.1 o, and 77.3 o. Average preoperative pain VAS and MEPS were 5.5 and 67.5. Average postoperative pain VAS and MEPS had been changed into 0.4 (p ＜0.001) and 97.5 (p＜0.001). Eleven patients returned to play. Ten cases returned to their own position. No patients were performed other operation for elbow pain. The arthroscopic osteophyte resection in valgus extension overload syndrome with low grade medial ulnar collateral ligament (MUCL) injury or without MUCL injury was a one of the ideal treatment option for early return to pre-injury levels and relief of pain.

Keywords: Valgus extension overload, Posterior impingement, Arthroscopy, Baseball

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Fig. 1.
Preoperative sagittal section image (A) and 3 dimensional reconstructed images (C, E) there are osteophyte in posteromedial side of olecranon (white arrow). Postoperative sagittal section image (B) and 3 dimensional reconstructed images (D, F). It was observed resected osteophyte after surgery.
kjsm-31-45f1.tif
Fig. 2.
It is seen preoperative olecranon osteophyte (A) and resected osteophyte is seen after surgery (B) in arthroscopic views.
kjsm-31-45f2.tif
Table 1.
Detailed data of patient history and medial ulnar collateral ligament state
Case No. Age (y) Career (y) Duration (mo) Postion Medial unlar collateral ligament state
Preoperative Postoperative
1 15 7 12 P O Partial tear
2 31 21 24 P P Partial tear
3 15 6 24 I I Normal
4 15 8 3 C C Partial tear
5 17 7 2 P P Normal
6 19 9 6 O O Normal
7 19 9 1 I I Normal
8 15 1 10 O O Partial tear
9 26 10 12 P Fail* Normal
10 15 5 36 P P Partial tear
11 22 12 24 O P Partial tear
12 16 7 1 I I Partial tear

Duration: period of pain onset to surgery, position: position of baseball player, P: pitcher, O: outfielder, I: infielder, C: catcher.

* Case No.9: fail due to shoudler operation (superior labrum anterior to posterior lesion).

Table 2.
Visual analogue scale (VAS) and Mayo elbow performance score (MEPS) changes were statistically significant (p＜0.05) between preoperation and postoperation
Characteristic Preoperative Postoperative p-value
Range of motion      
   Flexion contracture 2.3±4.1 0.7±1.7 0.19
   Further flexion 138.2±6.0 137.3±6.8 0.73
   Supination 69.1±12.2 77.3±4.7 0.39
   Pronation 76.4±9.2 79.1±3.0 0.55
Pain VAS 5.5±1.1 0.4±0.7 0
MEPS 67.5±13.2 97.5±2.6 0

Values are presented as mean±standard deviation.

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