Tommy John surgery is the procedure used to reconstruct or repair an injured elbow ulnar collateral ligament (UCL). This surgery was named after former Los Angeles Dodgers pitcher, Tommy John, since he was the first person to undergo this procedure in 1974. Since that time, this procedure has become very common, with about 10% of major league baseball pitchers have undergone this procedure. This surgery aims to reduce pain, stabilize the elbow, and restore range of motion. The UCL connects the humerus to the ulna, which is a bone in the forearm. While anyone can experience this injury from repeated stress or trauma, this injury most commonly occurs in throwing athletes since throwing motions place pressure on the ligament.
The first-line treatments include rest, anti-inflammatory medications, and structured physical therapy. Physical therapy treatments will strengthen the muscles around the elbow and shoulder to compensate for the injured ligament. When conservative remedies fail, surgery is indicated. This surgery involves taking a tendon from elsewhere in the body and replacing the damaged ligament with it. The tendon graft is weaved through the bone in the forearm and the humerus. Although the surgery only takes around one hour, the recovery time can be a lengthy process. It can take approximately four months for athletes to return to throwing. They do not start pitching until seven months after the procedure, and high-level athletes usually don’t get back to playing competitively until nine to twelve months after the procedure. The good news about this procedure is that 90% of cases have successful outcomes and athletes get back to their previous performance level.