{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T07:16:22Z","timestamp":1793862982422,"version":"4.6.1"},"reference-count":37,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Journal of Sports Medicine"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The Major League Baseball (MLB) Health and Injury Tracking System (HITS), created in 2010 with the MLB Players Association, was designed to overcome limitations of injured list-based reporting. It serves as a longitudinal injury surveillance platform and electronic medical record across major and minor league players.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To evaluate all publications related to the HITS database to provide an overview of epidemiology, treatment outcomes, and return-to-play (RTP) rates in professional baseball, guiding player safety and performance strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Scoping review; Level of evidence, 4.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>All peer-reviewed publications utilizing the HITS database (2010-2023) were reviewed under PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Studies reporting epidemiology, surgical versus nonoperative management, and RTP outcomes across upper extremity, lower extremity, spine, and other injuries were synthesized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>From 2011 to 2016, HITS recorded 49,955 injuries, resulting in 722,176 missed days of play. Pitchers accounted for 39% of injuries, with the upper extremity most affected (39%). Ulnar collateral ligament (UCL) injuries, while the sixth most common, represented the leading cause of surgery (46%) and season-ending injuries (60%). RTP following UCL reconstruction ranged from 73% to 84%, though outcomes declined with revision procedures. Shoulder injuries were also prevalent: labral repairs showed moderate RTP rates (74%-82%), whereas rotator cuff repair yielded poor outcomes (14%-42%), leading to preference for nonoperative care. Lower extremity injuries included hamstring strains, hip\/groin injuries, and meniscal pathology, with variable RTP timelines. Core injuries, lumbar spine disorders, and concussions also contributed significantly to time lost. Overall, HITS has informed &gt;40 publications, highlighting variable outcomes by injury type, treatment, and player position.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The HITS database provides the most comprehensive epidemiologic resource on injuries in professional baseball, identifying high-risk conditions and characterizing management outcomes. RTP success varies widely, with certain injuries such as UCL reconstruction yielding relatively favorable results, while others such as rotator cuff repair remain challenging.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23259671261419846","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T11:05:09Z","timestamp":1773227109000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Major League Baseball Health and Injury Tracking System (HITS): A Review of MLB Injuries Documented in the HITS Database Since Its Inception"],"prefix":"10.1177","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9802-290X","authenticated-orcid":false,"given":"Bradley A.","family":"Lezak","sequence":"first","affiliation":[{"name":"NYU Langone Orthopedics, NYU Langone Health, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter N.","family":"Chalmers","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, University of Utah, Salt Lake City, Utah, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon J.","family":"Erickson","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Northwell Health, Westchester, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4848-3411","authenticated-orcid":false,"given":"Anthony A.","family":"Romeo","sequence":"additional","affiliation":[{"name":"Adventist Medical Center Hinsdale Hospitals, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,3,5]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546514529083"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/2325967117694025"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2018.01.024"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/2325967119864104"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546518765158"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546519832525"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/19417381221093557"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/23259671231191223"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/03635465241243244"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546519876305"},{"issue":"3","key":"e_1_3_2_12_2","first-page":"168","article-title":"The epidemiology of hip and groin injuries in professional baseball players","volume":"45","author":"Coleman SH","year":"2016","unstructured":"Coleman SH, Mayer SW, Tyson JJ, Pollack KM, Curriero FC. 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