Does Tommy John Surgery Affect A High School Pitchers’ Chance to Play In The Big Leagues?

Every high school and collegiate baseball pitcher dreams of making it to the big leagues. Unfortunately for some, these dreams are knocked down by Ulnar Collateral Ligament (UCL) injury.

My mission is to keep dreams alive. The largest proportion of TJ surgery I currently perform are in high school athletes. Second largest proportion is college athletes.

This past MLB amateur draft, I was thrilled that several patients I had the privilege of helping with TJ surgery were selected. In that same week however, I had to break the MRI findings of UCL injury to several patients and their families and tell them that TJ surgery may be their best option to return to pitching.

“If I go forward with Tommy John surgery, can I still go on to play professional baseball?”

This is a common question from patients and families as they absorb the news of UCL injury.

This question can be precisely answered with research. I lead a specific study that analyzed the outcome of Tommy John surgery performed on amateur athletes who were subsequently selected in the MLB draft. To do this we used an MLB amateur draft database and identified all pitchers who underwent a Tommy John surgery before being drafted from 2005 to 2014. A total of 345 pitchers were identified.

The analysis revealed that the number of pitchers selected that had already had Tommy John surgery, has been rising steadily from 2005 to 2016. The analysis further revealed that Tommy John surgery drafted pitchers when compared to pitchers who did not have surgery, reached the major-league level with greater frequency — 20% versus 12%. In addition, compared to pitchers who did not have Tommy John surgery, Tommy John surgery pitchers demonstrated an increased likelihood of reaching progressive levels of play within a given time frame. More simply stated, players with Tommy John surgery advance to higher levels of professional baseball faster than those patients who did not have Tommy John surgery.

Young right-hander Montana Semmel rebounded from TJ surgery with Dr. Ahmad and signed with the Yankees

This is the first study to define the professional playing future of a high school or college athlete who undergoes Tommy John surgery. The exact reasons for the success of Tommy John surgery drafted into professional baseball, however is not explained in the study. It is plausible that pitchers who successfully undergo Tommy John Surgery may be more talented or possibly more durable than the non-Tommy John surgery pitchers. Another potential explanation is that patients who successfully complete the rigorous and lengthy process of rehab and surgery acquire certain knowledge, skills, preparation strategy and recovery techniques that are advantageous to performance and advancement in level of play. It is also possible that MLB organizations increasingly scrutinize pitchers with a history of Tommy John surgery and bias the selection of Tommy John pitchers only if they possess more talent potential.

Dr. Ahmad and his colleagues published this research the American Journal of Sports Medicine in 2018.

The number of pitchers selected in the MLB draft that had already had Tommy John Surgery, has been rising steadily since 2005