The Tommy John surgery is used to repair an elbow ligament that is damaged. The procedure is commonly performed on athletes particularly the pitchers in baseball but it is also done on younger individuals. This surgical procedure is also called UCL (ulnar collateral ligament) reconstruction. During a Tommy John surgery, the surgeon replaces the damaged UCL with a tendon that was taken from another part of the body.
How UCL injuries occur
The UCL is situated on the interior of the elbow which is responsible for connecting the bone of the humerus to a bone in the forearm. Any individual can sustain an UCL injury from constant stress to the elbow or due to trauma. This is the reason why sports involving repetitive throwing put individuals at high risk. Take note that the throwing motion that twist and bend the elbow puts great stress on the ligament. Over time, the UCL can develop miniature or large-sized tears. The ligament stretches and lengthens to a point where it could no longer hold the bones in a secure manner during throwing movements. Aside from baseball, other sports that can cause UCL injuries include tennis, javelin throw, softball, gymnastics, soccer, football and wrestling.
Symptoms of UCL injuries
- Pain on the interior of the elbow
- Looseness or instability in the elbow
- Diminished ability to throw objects
- Irritation of the ulnar nerve which is felt as the tingling in the ring or small finger
Treatment for UCL injuries
Most of the UCL injuries are initially treated with first aid measures which include rest, application of ice and administration of NSAIDs. Individuals will then undergo physical therapy in order to strengthen the surrounding muscles. In some cases, athletes are considered candidates for the surgery right away. The Tommy John surgery is recommended for individuals who do not respond to non-surgical treatments and those who want to resume strenuous throwing activities.
What happens during a Tommy John surgery?
When a Tommy John surgery is performed, a tendon is taken from another body part such as the hip, wrist, hamstring, knee, foot, toe or forearm. The surgeon will drill tunnels in the ulna and humerus. The tendon is passed through these tunnels and woven into a figure-eight pattern to reconstruct the ligament. For extra strength, any remaining parts of the original ligament are connected to the tendon. Complications can develop but it depends on the technique that is used by the surgeon. The most common complication in most cases is the damage to the ulnar nerve. Other possible complications include hematoma or infection. The rehabilitation after undergoing the surgery typically takes a year. In some, it can take up to 2 years so that the individual can return to the previous level of fitness. Due to the advancements in the medical field, individuals who undergo the Tommy John surgery are able to resume their sport at their previous level of competence or even higher.