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Return to Sport and Performance After Thumb Metacarpophalangeal Joint Collateral Ligament Surgery in the National Basketball Association
Brendan M Holderread, MD1; Jordan Jafarnia, B.S.1; Brian M Phelps, MD1; Mark Perrin, B.S.1; Joshua D. Harris, MD2; Shari R Liberman, MD1
1Houston Methodist Hospital, Houston, TX; 2Orthopedics and Sports Medicine, Houston Methodist Hospital, Houston, TX

Background: Injuries to the thumb represent 2.7% of all National Basketball Association (NBA) game-related injuries. Ligamentous thumb injuries are commonly characterized as ulnar collateral ligament (UCL) or radial collateral ligament (RCL) sprain or tears. Thumb collateral ligament injuries occur from a variety of mechanisms including catching a ball, attempted forceful grasping, or falling on an abducted thumb. As basketball has become a more physical sport, NBA players are at increased risk of thumb collateral ligament injury. Currently injuries are treated both non-operatively and operatively depending on the type and severity of injury.
Purpose: The purpose of this study was to identify NBA players who underwent thumb collateral ligament surgery (UCL or RCL) in order to evaluate: (1) Time to return to sport; (2) Post-injury career length compared to matched controls; (3) Compare preoperative performance to postoperative performance; and (4) Compare post-injury performance to matched controls.
Methods: NBA players with thumb collateral ligament surgery were identified using a previously used systematic search strategy of publicly available data. Performance statistics, ligament injuries (UCL or RCL), return to sport (RTS) time, laterality, and injury dates were recorded. Cases were matched 1:1 with controls based on age (1 year), BMI, NBA experience (1 year), and performance statistics prior to the index date. RTS required playing in one NBA game post-operatively. Career survival was evaluated. Summary statistics were calculated and student t-tests (?=0.001) performed.
Results: RTS rate was 100.0% (33/33, Age: 26.93.0). Career length (Case: 9.64.1, Control: 9.44.3, p >0.001) was not significantly different from controls (p>0.001). Same season time to RTS (n=20) was 7.12.4 weeks. Off-season or season-ending surgery (n=13) RTS time was 28.418.7 weeks and significantly different from publicly available reports (6.20.7 weeks, p<0.001). Neither thumb collateral ligament (UCL, n=7; RCL, n=10; Unknown, n=16) had an identifiable difference between the groups when evaluating career length. Career length, games/season, and performance was not different for players that underwent surgery on their dominant thumb (63.6%, 21/33) compared to controls (p>0.001).
Conclusions: RTS rate is high in NBA athletes undergoing thumb collateral ligament surgery. Players do not experience decreased performance or career length due to thumb collateral ligament surgery, regardless of dominant or non-dominant thumb injury.



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