Tommy John Surgery is an operation that replaces your torn UCL with a tendon from another part of your body to reduce or eliminate pain while increasing stability and range of motion.
Throwing athletes often seek UCL support, such as baseball pitchers, who place tremendous strain on their UCL through repetitive throwing motions.
What is the Ulnar Collateral Ligament (UCL)?
The Ulnar Collateral Ligan (UCL) is a band of tough tissue that helps stabilize your elbow joint. It connects your upper arm bone (the humerus ) with your lower arm bone (ulna). Repetitive overhead activities like baseball, javelin, or racquet sports often damage this ligament over time, leading to a repetitive strain injury, causing pain inside your elbow and decreased throwing power. Over time repeated stress on this UCL may tear it entirely and result in painful symptoms including pain on its inside as well as reduced throwing power resulting from this ligament’s repeated stress on an ongoing basis causing pain on its interior as well as power losses due to loss of control from throwing sports injuries causing cumulative strain damage to tear over time with repeated stress leading to tears inflicting damage due to repetitive stress on it from overhead activity like throwing sports such as baseball javelin, or racquet sports throwing sports repetitive overhead activity or repeated stresses on its inside edge or tear leading up over time can result in pain on its interior as well as power losses due to decreased throwing power loss due to reduced throwing power loss from overuse injuries suffered over time due to repetitive stress on its inner surface resulting from repeated stress on its outer edge as resulting from pain from within and pain on its outer edge causing gradual destruction or tear leading upstream over time due to repetitive stress on its protective covering over-exerating activity or repeating activity such as baseball javelin or racquet sports throwing sports activity over their repetitive stress from repeated strain. Over time and stress causes tears causing, pain on it causing loss as loss due to lack of throwing power, loss in overtime cause loss a tear a resultant pain at least until it eventually occurs overtime leading to prolonged strain, causing its weakening over exertion within its presence, leaving it vulnerable surrounding.
Tommy John surgery involves replacing your damaged UCL with a tendon from another body area. A surgeon drills holes into both your upper arm bone and ulna bones before threading new tendons through these holes using techniques such as docking or figure-8 grafting to secure it with sutures, screws, or buttons.
Doctors will also utilize imaging tests like X-rays and computed tomography (CT) scans as part of your surgery. These scans allow them to see bone issues like stress fractures while being unable to identify soft tissue injuries such as torn UCL. MRI may be recommended with a unique dye injection into your elbow, making difficult-to-see issues easier to spot.
What Causes a UCL Tear?
UCL tears can leave your elbow feeling painfully loose. While UCL tears tend to occur more commonly among pitchers, other athletes who regularly throw or apply significant stress on the inside of their elbow – such as players of racquet sports, football, javelin throwing, or volleyball can also experience this injury.
If your ligament has completely ruptured or there’s been an unexpected pop in your elbow, seek medical help immediately. They will perform a physical examination and use imaging technology such as an MRI scan to assess the damage; soft tissue injuries often don’t appear on an X-ray image. Your physician may also perform a Valgus Stress Test, which applies pressure to your elbow joint to detect excessive movement – an essential aspect of diagnosing UCL tears, including fluoroscopy showing your actions live.
Tommy John surgery involves replacing damaged ligaments with tendons from another area of your body or a donor. Your surgeon then passes this graft through tunnels in your bones – two on the ulna and three (in a Y-shape pattern) on the humerus. The remaining parts of the original ligament are attached to this new one to strengthen it further; typically, recovery takes nine months to a year before returning to sports activity.
What is Tommy John’s Surgery?
UCL reconstruction surgery, or Tommy John surgery, is an incisional procedure to repair an injured UCL in your elbow joint. Your surgeon will use a healthy tendon from elsewhere on your body or a donated one as the new UCL, attaching the tendon using docking techniques such as sutures or buttons and reinforcing it against both bones in your upper arm (humerus) and forearm bone (ulna).
Tommy John surgery is typically outpatient, meaning you’ll return home the same day. Your physician will administer both general anesthesia and possibly regional anesthesia to minimize discomfort throughout the procedure.
Your doctor will make a three to four-inch incision on the side of your elbow and move muscles and other tissues out of their way to access the damaged area, including dead or unhealthy tissue removal, ligament testing, and strength evaluation. After surgery, they’ll place your elbow in a rigid splint to limit movement before beginning physical therapy treatments to strengthen and retrain it; rehabilitation could take nine months to one year before returning to competitive throwing sports.
How Does Tommy John’s Surgery Work?
When your UCL is healthy, it protects the inside of your elbow from the force that pushes away from you and toward your hand. Over time, however, repeated stress may cause it to tear, leaving your elbow without support and leading to severe pain and inflammation. This injury could potentially require surgical repair.
After an injured ligament cannot heal, you will require Tommy John Surgery to replace it with a new one. Your surgeon creates this replacement ligament by transplanting a healthy tendon from somewhere in your body or using one donated by another source before stitching the graft directly to your bone.
Your doctor will make an incision on the inside of your elbow, clearing away tissues that might obstruct assessment while creating two or three tunnels between the ulna and humerus bones (in a Y-shape pattern) so they can thread in the graft material.
After your surgeon stitches the graft into your elbow bones, healing time should pass quickly, and you can start physical therapy sessions that include throwing exercises. Most athletes return to competition once rehabilitation has concluded.
How Long Does Tommy John’s Surgery Take?
Undergoing Tommy John surgery typically becomes necessary after multiple attempts at noninvasive treatments have failed, including rest, sports medicine, ice, and taking nonsteroidal anti-inflammatory drugs (NSAIDs).
At Tommy John surgery, your surgeon will replace your injured UCL with a tendon from another part of the body – such as a lower leg, forearm, or hamstring tendon from another arm of your uninjured arm or even one taken from a deceased donor – while simultaneously clearing away scar tissue in preparation for inserting the new tendon.
Your doctor will then use drill holes drilled into both bones connected by the UCL: upper arm bone or humerus and lower arm bone or ulna – then thread the new tendon through those holes using techniques such as docking before securing it with sutures, screws, or buttons.
Once your doctors are confident of a successful repair, they will place your elbow in a hinged brace and monitor its progress through rehab. Each athlete’s timeline varies; typically, 12-18 months are required before total throwing capacity can be returned to the sport.
What are the Side Effects of Tommy John Surgery?
Before the advent of Tommy John surgery in 1974, an injury to an athlete’s UCL could often mean the end of their athletic career. However, around 85% of athletes who undergo this surgery can return to previous performance levels after this procedure, though their ligament is susceptible to further injuries if neglected.
The procedure involves replacing damaged ligaments with tendons from another part of the body – typically the hamstring – via incision made on the inner elbow and transplanting a healthy tendon to replace damaged one. Once installed, this new ligament is secured by drilling holes through which its tendon is threaded and secured with sutures, buttons, or screws for added security.
After surgery, some patients may experience complications such as stiffness or swelling of the elbow joint. To minimize these side effects, follow your doctor’s recommendations for recovery; this may include avoiding activities that increase the risk of an elbow injury and following an appropriate exercise program; anti-inflammatory medication prescribed by your doctor can also help.
What are the Risks of Tommy John Surgery?
Professional athletes or those involved with throwing sports (like baseball pitchers) frequently require Tommy John surgery. Many young athletes have returned to competitive activity after this procedure, and recovery was relatively swift.
At Tommy John’s surgery, surgeons replace damaged UCL ligaments with tendon grafts sourced either from within the patient or from external sources such as donors. Once attached, this tendon graft helps stabilize elbow joint movement.
Surgery for elbow arthritis typically lasts around an hour as an outpatient procedure. An orthopedic surgeon will make a 3- to 4-inch incision on the inside of your elbow for this process.
After extracting the damaged ligament, holes must be drilled in both bones initially connected by the UCL: upper arm bone (humerus) and lower arm bone (ulna). Next, the tendon graft must be secure and threaded through these holes using sutures, buttons, or screws.
As soon as they are out of surgery, patients should wear a cast or splint and gradually begin moving their arms again. Any discomfort should be managed using over-the-counter pain relievers; physical therapy is also vital in healing as it will increase the elbow joint’s range of motion and strength.
