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Tommy John Surgery Made Simple

Tommy John Surgery is more formally referred to as ulnar collateral ligament (UCL) reconstruction. The operation replaces the damaged UCL with a tendon from the forearm or hamstring. The procedure was developed by Dr. Frank Jobe in 1974 for pitcher Tommy John for whom the surgery is named. Prior to Dr. Jobe’s innovation, UCL injuries were career ending

Illustrations shown are from Dr. Ahmad’s book for youth baseball players – Click here to check it out

UCL injuries result from repetitive, forceful use of the elbow such as baseball pitching. Players with more severe UCL injuries typically require Tommy John Surgery. The surgical procedure involves implanting a new tendon into drill holes made in the bones of the elbow. The tendon is weaved through the drill holes and then pulled tight and sewn together. The original ligament can also be sewn into the new reconstructed ligament to add further strength.

Tommy John Surgery has saved the careers of thousands of professional and amateur baseball players, Javelin throwers, wrestlers, gymnasts, tennis players, and football players.

Tommy John (left) and Dr. Frank Jobe, inventor of Tommy John Surgery

Tommy John and Dr. Ahmad in 2007 at the New York Orthopedic Hospital Alumni Biennial Meeting

Understanding the Epidemic of Elbow Baseball Injuries

My office is filled with injured athletes and with each passing year, the athletes are younger than previous years. The fact is that Tommy John injuries are becoming more and more frequent in the young athlete, which has lead my team and I to dedicate and focus our research.

  • Are more pitchers actually hurting their elbows?
  • Are the sports physicians and athletic trainers simply getting better at diagnosing injuries?
  • Are pitchers more open about admitting their injuries?
  • And the biggest question of them all: Are teams and parents just pushing for surgery?
  • What are the risk factors for injury?
  • How can Tommy John Injury be avoided?

The answers to these questions are not as concrete as we would like. What we do know is that we have a Tommy John Injury crises and we are trying to solve it.

Youth Player STATS

  • 16 million youth baseball players worldwide and 20 percent of them between the ages of 9 and 15 will seek medical attention.
  • The medical cost of these injuries is close to $1.8 billion and 50 percent of these injuries are related to overuse, meaning they are preventable! This is especially true for the pitcher, who is at most risk for an elbow injury.
  • At the time of this writing, the prevalence of Tommy John Surgery in professional baseball pitchers at the major league level is 25% and these numbers continue to climb.
  • The 17 and 18-year-old age group undergoing Tommy John surgery is growing at a faster rate than any other age group. In fact, I published research demonstrating that the high school age group undergoes Tommy John surgery more than college or professional players.

Professional Player STATs

  • In Major League Baseball, from 2000 through 2011, approximately 16 pitchers per year underwent Tommy John Surgery, peaking at 20 in the 2007 season.
  • In 2012 and 2014, the number of Tommy John Surgeries sharply increased to 36.
  • Since the first operation 41 years ago, just shy of 1,000 known UCL surgeries have been performed on major and minor league players, the vast majority of them pitchers.
  • 70% of Tommy John Surgery in MLB occurred in the past decade.
  • The number of MLB draft picks who have already had Tommy John surgery is increasing each year.
  • Players having a second Tommy John Surgery is increasing dramatically.

UCL anatomy

UCL Reconstruction AKA Tommy John Surgery

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