Dr. Adolph Lombardi Jr.
Hip, Knee
Tommy John Surgery
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The world of sports medicine has transformed the lives of athletes, particularly baseball pitchers, through innovative procedures such as Tommy John Surgery. In this article, you’ll learn everything you need to know: from what it is and who needs it, to recovery times, benefits, and success rates.
JIS Orthopedics in New Albany and St. Clairsville, OH, offers expert evaluation and treatment for athletes of all levels. Contact us today to schedule an appointment or to discuss whether Tommy John Surgery is right for you.
What is the Tommy John Surgery?
Tommy John Surgery, medically known as ulnar collateral ligament (UCL) reconstruction, was pioneered in 1974 by Dr. Frank Jobe, a surgeon. It involves replacing a torn ulnar collateral ligament in the inner elbow with a tendon graft, often harvested from the forearm or leg.
This procedure is especially prevalent among those who play sports that involve overhead throwing and racquet sports players. Its goal is to restore stability and strength to the elbow after a ligament tear from valgus stress during repetitive throwing motions.
Conditions it Helps to Treat
Professional athletes with UCL injuries may be good candidates for Tommy John surgery. These types of injuries are usually caused by overuse in those who participate in throwing sports. They may include the following:
- Softball or baseball pitchers
- Javelin throwers
- Football throwers
- Tennis players and others who participate in racquet sports.
Those who play these sports for fun usually recover with rest and conservative treatment. Professional athletes, on the other hand, usually have a higher play load, and the extent of injury can worsen over time and require UCL reconstruction.
Candidates for Tommy John Surgery
Ideal candidates typically include:
- Baseball pitchers, throwing athletes, and other athletes experiencing prolonged elbow pain
- Individuals with confirmed UCL tears via imaging and clinical exam (like the valgus stress test)
- Athletes who feel pain during the throwing motion or have mild discomfort that limits performance despite conservative management
- Those who have undergone Tommy John Surgery before and have re‑injured the ligament
What to Expect Before and During UCL Repair
Knowing what to expect at each stage of Tommy John Surgery can help reduce anxiety and ensure you’re fully prepared for a smooth recovery process.
Pre‑Surgery
Your surgeon will evaluate the severity of the torn ulnar collateral ligament and determine if UCL repair or full reconstruction is the most appropriate approach.
- You’ll undergo a detailed evaluation by a doctor specializing in musculoskeletal medicine or orthopedics, including imaging and physical exams.
- Nonsurgical treatments such as rest, bracing, and rehab are tried first unless there’s a complete tear.
- Once the decision is made, your surgical team walks you through preoperative prep, potential risks, and the Jobe technique or alternative methods like the docking technique (which uses fewer holes in the bone).
Surgical Procedure
During the operation, your surgical team will reconstruct the damaged UCL using a tendon graft to restore strength and stability to the elbow.
- Typically done as an outpatient procedure, you receive anesthesia, and the surgeon harvests a healthy tendon (e.g., palmaris longus) from the patient.
- The ligament reconstruction involves drilling small tunnels in the upper arm bone (humerus) and forearm bone (ulna), then threading the new UCL graft in place.
- The process takes about 1–2 hours, depending on technique and complexity, with careful handling of the ulnar nerve to avoid postoperative numbness.
Recovery
Rehabilitation after Tommy John is a multi‑phase journey:
- Immediate postop: Your elbow is immobilized in a brace at a 60 to 90 degree angle.
- At one or two weeks: You will begin elbow movement to help improve range of motion
- About six weeks: Progressive strengthening begins, focusing on shoulder, arm, and core
- Around three to four months: You will begin light throwing and functional drills
- By nine to 12 months: You will gradually return to competitive throwing, with many baseball pitchers reaching full recovery
- Between 12–18 months: Most athletes return to their pre‑injury level of play
The longevity and strength of the ulnar collateral ligament after reconstruction are impressive, with many players returning stronger than before.
Benefits
Tommy John Surgery offers the following benefits:
- Restores elbow stability in athletes who feel pain with throwing
- Enables a return to competitive sports, often at the same level or higher
- Allows athletes to continue their career with few or mild long‑term issues
- Compared to conservative treatment, it offers more reliable outcomes for complete UCL tears
Surgery Success Rate
Success rates for Tommy John Surgery are high:
- Approximately 80–90 % of athletes return to major league or collegiate play
- While not guaranteed, most athletes experience minimal complications, such as stiffness or ulnar nerve irritation
- Newer docking technique and improved rehab protocols have further enhanced success
A Center of Excellence for Elbow Care
At JIS Orthopedics, we offer comprehensive evaluation and expert surgical care for elbow injuries, including Tommy John Surgery. From accurate diagnosis to tailored recovery plans, our surgical team and sports medicine experts guide you every step of the way.
If you’re experiencing pain in your inner elbow, have been diagnosed with a torn UCL, or want to explore treatment options, get in touch with us today. Our offices in New Albany and St. Clairsville, OH, are ready to help you get back on the mound, court, or field. Contact us now to begin your journey to full recovery.
Medically reviewed by Dr. AJ Julka
JIS Orthopedics Can Diagnose & Treat Your Injury, And Help You Recover
If you are experiencing symptoms related to tendonitis, it is important to contact your doctor and address the condition before it worsens and prevents you from doing the things you love. Schedule an appointment with JIS Orthopedics today! We’d love to help you get your body back on track!
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