Alteration in stress distribution patterns through the elbow joint in professional and college baseball pitchers: Using computed tomography osteoabsorptiometry

Abstract

BackgroundLong-term pitching activities change the stress distribution across the elbow joint surface in living subjects, however the influence of the different strength of stress on the stress distribution patterns remain unclear. The aims of this study were to evaluate the distribution of subchondral bone density across the elbow joint in different levels of pitchers, and to reveal the influence of the strength of stress on the elbow joint surface under long-term loading conditions of baseball pitching. MethodsThe current analysis was performed using computed tomography (CT) image data obtained from the throwing side elbow of 12 nonthrowing athletes (controls), 15 college baseball pitchers (college group) and 13 professional baseball pitchers (professional group). The distribution patterns of subchondral bone density through the articular surface of the elbow joints were assessed using a CT osteoabsorptiometry method. The quantitative analysis was based on location and percentages of high-density area on the articular surface. ResultsHigh-density area in the college and professional groups were found in the anterior part of the captellum, posterior part of the trochlea and radial head. In the professional group, the percentages of high-density area in the anterior part of the capitellum, posterior part of the trochlea, radial head and olecranon were significantly greater than in the college group. ConclusionsStress distribution on the articular surface of the elbow joint was affected by pitching abilities or competitive levels. Our analysis indicates that high strength of stress in professional baseball players produce potential risk of elbow injuries.