Return to Sport Criteria and Outcomes in Javelin Athletes Following Ulnar Collateral Ligament Reconstruction: a Systematic Review.

Only 34 athletes in total, and only three of them female, so the authors say they cannot be confident the results apply to javelin throwers more widely. Surgical technique and graft choice differed between studies and within them, so the effect of those decisions cannot be separated from anything else. Follow-up varied from 24 months to 9.6 years, so the studies are not describing the same period after surgery. Three of the four studies had operations performed by more than one surgeon, adding further uncertainty. The patient-reported questionnaires were not consistent across studies, and two of them, the Timmerman-Andrews and Conway-Jobe scores, have not been validated and have no agreed minimum important difference. Quality scores were 44 to 61 out of 100, rated fair to poor, and all four studies were level IV evidence. Only English-language studies were included. The studies were too different in their outcome measures for the authors to draw one set of results from them.

Do not read the 62.5% to 100% return-to-sport range as a javelin-specific success rate to quote to an athlete. It comes from four level IV studies of 34 athletes, rated fair to poor, in which the only criterion for clearing someone was finishing a protocol on time and no physical or functional testing was done.