Tommy John Surgery
When a patient has a torn Ulnar Collateral Ligament, or UCL, a surgeon performs Tommy John Surgery. In Tommy John surgery, a surgeon replaces the torn ulnar collateral ligament with a healthy ligament from elsewhere in the body. Surgeons typically perform Tommy John surgery for patients who injured the UCL from overuse rather than trauma. A very common sports medicine injury in baseball players, Tommy John surgery gets its name from baseball pitch Tommy John, who first received the surgery in 1974 by Dr. Frank Jobe.
How Surgeons Perform Tommy John Surgery
While doctors perform alternative methods including Platelet Rich Plasma (PRP) and Stem Cells to treat Tommy John Surgery, the preferred method remains surgical intervention. To begin surgery, the upper extremity surgeon harvests the graft. The graft comes from the patients body or in certain cases a donor. Grafts for UCL repairs typically come from:
To remove damaged tissues, the surgeon makes a 3-4 inch incision on the outside of the elbow and assesses all damage. Once all damaged tissues get removed, the surgeon drills holes into the humerus and ulna to attach the graft. Surgeons typically use sutures, buttons, or screws to secure the graft.
Risks Associated with tommy john surgery
Every surgery comes with its risks. Risk of infection or complications with anesthesia may arise, in addition to nerve or blood vessel damage. Graft related complications include the graft rupturing or stretching, or issues at the graft harvesting site.
Rehabilitation following Tommy John Surgery
Surgeons stress the importance of post operative rehabilitation in relation to Tommy John Surgery, especially for athletes hoping to return to a sport. The treating doctor prescribes a brace post operatively that the patient wears for about a month. The brace gets worn at a 60-90 degree angle to protect the healing UCL and surrounding tissues. Physical therapy starts immediately following surgery to reduce the risk of muscle atrophy. After two weeks in a brace, the patient can move the elbow joint. A patient may still have to wear a brace, with range of motion gradually increasing. After one month post operatively the elbow may fully extend. It may take two to four months for the patient to regain full range of motion following Tommy John Surgery.
For athletes recovering from Tommy John Surgery, rehabilitation takes a longer time. Most athletes can expect to return to sport between 6 and 9 months. Returning to competition within those competitive sports usually takes 9 months to a year. Once back in athletics, patients must continue a rehabilitation regimen to increase strength.