In the world of major league baseball, Tommy John surgery is literally a game-changer.
The surgery has saved the careers of hundreds of major league baseball players, leading one Sports Illustrated writer to dub it “the most important sports medicine procedure in baseball history.”
Nicknamed for Tommy John, the first player to undergo the procedure, ulnar collateral ligament reconstruction was first performed in 1974 by Los Angeles Dodgers team physician Dr. Frank Jobe. He transplanted an unneeded tendon from John’s right wrist into his left elbow, where it functioned as a new ligament. John went on to win another 164 games.
Since then, more than 500 major league baseball players have undergone “Tommy John surgery,” and the National Baseball Hall of Fame honored Dr. Jobe before he passed away in 2014.
Dr. Karim A. Meijer, M.D., an orthopaedic surgeon on the medical staff of Texas Health Center for Diagnostics & Surgery in Plano, specializes in the procedure.
“The repetitive stress of throwing can stretch, fray or tear the ulnar collateral ligament (UCL) of the elbow,” Dr. Meijer explains. “With Tommy John surgery, we make a small incision (3”-4”) on the medial side of the elbow, and the transplanted tendon is anchored into the bones of the elbow.” The procedure lasts 60-90 minutes and is done on an outpatient basis, with the patient returning home the same day.
The story of that first surgery was chronicled in a 2013 ESPN 30 for 30 documentary. In 1974, Dr. Jobe estimated the odds of success for the new surgery at one in 100. But without it, John’s career was over, so he gave it a try. Dr. Jobe recalled nervously watching John’s first few games post-surgery, worried the transplanted tendon would fail. It never did; John played 14 more seasons until he retired from the game at age 46.
“The odds of success have improved considerably since then, largely due to the work of my mentor, Dr. James Andrews, and his team,” said Dr. Meijer. “About 85-90 percent of athletes return to playing at their previous level of performance or better.”
In fact, Tommy John surgery has been so successful that physicians worry that players and coaches have become complacent about injury prevention as a result. Many athletes believe that the surgery can enable players to throw even better than they did before the surgery. In 2011, researchers surveyed 189 baseball players ages 10-to-23 and found that 50 percent of high school athletes believed that Tommy John surgery should be performed in the absence of injury to improve performance. Some surgeons have received queries from parents who are considering the surgery for their un-injured sons.
“That’s not advisable,” said Dr. Meijer. “Most surgeons believe that any post-surgical improvements in performance are due to increased attention to fitness, education, and proper mechanics, not the surgery itself.”
Also, Tommy John surgery requires a long period of recovery. Full rehabilitation typically takes about one year.
Overuse is the number one cause of injuries; planning and proper conditioning can help reduce the risk. For guidance on preventing injuries, Dr. Meijer recommends the website Stopsportsinjuries.org.
Another good resource is “Throw Like a Pro,” an app that helps young players prevent elbow overuse. The app includes a pre-season preparation guide for players, information on warming up, pitch counts, proper throwing mechanics and much more.
Said Dr. Meijer: “The best medicine for elbow injuries is still prevention.”