Tommy John Surgery: Ulnar Collateral Ligament Repair

By:    Published: November 6, 2011

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Because of its location right at the joint of the upper and lower arm, the elbow is a somewhat common body part to become injured. It is particularly susceptible to injury in certain sports where the arm is used repeatedly, like baseball or tennis. One common surgery to repair an elbow injury is the ulnar collateral ligament surgery. This article will explore the history of this surgery, what it involves and the controversy that has sometimes surrounded the procedure.

History

Ulnar collateral ligament surgery has been performed for several decades. However, it wasn’t until the surgery was used to treat Tommy John, a professional baseball pitcher for the Los Angeles Dodgers whose ulnar collateral ligament had torn. At the time, his injury prevented him from ever pitching professionally again. John decided to receive the surgery in 1974 when the procedure was still very new and considered a radical, risky choice. At the time of his surgery, John was given a chance of 1 in 100 for a complete recovery of his arm. Fortunately for John, his surgery was a success and he returned to baseball to continue pitching for several more years.

The success of John’s surgery resulted not only in the procedure being commonly known by his name but also in the practice of more people – especially athletes – receiving the surgery to repair elbow injuries. Today, the surgery has come a long way to the point where the chances of complete recovery are closer to 83 percent.

Procedure Details

The purpose of Tommy John surgery is to replace a torn ulnar collateral ligament. In order to do this, a surgeon removes a tendon from another part of the body (usually the forearm or the hamstring) and grafts it into the elbow to replace the ulnar collateral ligament. To make the graft complete, holes are drilled into the ulna and humerus bones, and the tendon is laced through it in a figure-eight pattern.

In addition to being a serious procedure, the Tommy John surgery also involves a long recovery time. Athletes usually take a full year to return to their previous ability with lots of physical therapy in between.

Expected Results

After physical therapy and adequate rest has been completed, most people experience a full recovery from the surgery. In some cases, pitchers who have fully recovered from the surgery have ended up being able to throw harder than they did before the procedure was performed. For the average person, the surgery simply allows them to use their elbow joint at full capacity again and removes any pain associated with the injury to the area.

Since Tommy John received the surgery in 1974, many other professional baseball players have received the surgery as well, including Jose Canseco, John Franco and Kerry Wood. Additionally, several football players have also received the surgery, such as Deion Sanders, Rob Johnson and Craig Erickson. These players went on to receive a full recovery and many continued to play professionally for several years after the procedure was completed.

Concerns About the Tommy John Surgery

Though the surgery now has a higher rate of success than it was first completed, many people believe that the surgery may be performed too often. Since the surgery has allowed some athletes to actually throw harder than before the procedure, some athletes have tried to undergo the surgery before an injury even occurs. In extreme cases, some parents have even advocated for their uninjured child to receive the surgery in the hopes of improving his or her future performance. In general, many athletes and sports enthusiasts believe that performance-enhancing surgery creates an uneven playing field that puts some at a disadvantage.

In addition to the athletic disputes about the surgery, there are also some people who believe the procedure involves too many risks. Since major muscles and the ulnar nerve are detached during the procedure, it does pose a risk for infection, nerve irritation and numbness. Moreover, the holes that have to be drilled in the bones of the arm, there is also a risk for fracture during the surgery.

It’s important to consider all of the risk factors when thinking about undergoing the Tommy John surgery. If you believe you may benefit from this procedure, consult your doctor and get a referral for an experienced physician.

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