TUESDAY, March 11, 2014 (HealthDay News) -- So-called "Tommy
John" surgery is very effective at getting Major League Baseball
(MLB) pitchers back in the game, new research has found.
Four out of five MLB pitchers who underwent Tommy John surgery
to repair a torn elbow ligament eventually returned to play, and
pitched as well as they had before their injury.
They even won more often after their surgery compared to players
who never underwent the surgery, the study authors reported Tuesday
at the annual meeting of the American Academy of Orthopaedic
Surgeons (AAOS), in New Orleans.
"It used to be a career-ending injury. Today, it's a one- or two-season-ending injury," said Dr. William Levine, an AAOS spokesman and director of the sports medicine department of orthopedic surgery at NewYork-Presbyterian Hospital/Columbia University Medical Center.
Tommy John surgery fixes a torn ulnar collateral ligament, or
UCL. The UCL is located on the inside of the elbow and connects the
bone of the upper arm to a bone in the forearm.
This injury occurs in baseball mainly to pitchers, but it also
can affect catchers due to the number of times they throw during a
game, said Levine, who was not involved with the study.
"It's a repetitive overuse trauma scenario. The torque on the elbow is phenomenally higher than the ligament can stand," Levine said. He noted that the surrounding muscles and the players' own technique are the only things that prevent even more torn UCLs from taking place. "It's a mismatch of the force and energy that ligament sees versus what it can withstand," he explained.
In the procedure, surgeons replace the injured UCL with a tendon
taken from the player's own body, usually either the forearm or the
knee, Levine said.
The surgery is named after the first ball player to undergo the
procedure, former Los Angeles Dodgers pitcher Tommy John. His
surgery occurred in 1974.
In the study, doctors with Midwest Orthopaedics at Rush
University Medical Center in Chicago scoured MLB records to
identify pitchers who underwent Tommy John surgery between 1986 and
The researchers found 179 pitchers who underwent Tommy John
surgery and looked at their performance. "We took their stats from
before surgery and took their same data from after surgery, and
compared them," said study author Dr. Brandon Erickson, a resident
with Midwest Orthopaedics at Rush.
They also compared the players to a group of pitchers who never
Among their findings were the following:
The study was published recently in the
American Journal of Sports Medicine.
"The surgery is not 100 percent," Levine said. "But if you're a major league ball pitcher and you do have to have the surgery, knowing that 83 percent of your colleagues are able to get back to their previous level of performance is encouraging."
However, both Erickson and Levine expressed concern that these
findings might encourage younger players at the high school or
college level to undergo Tommy John surgery in the mistaken belief
that it could improve their game.
"If you are a college, junior high or high school player and you have to have Tommy John surgery before you get to the major leagues, it does not improve your chances of eventually getting to the major leagues," Levine said. "It doesn't make you stronger, better or faster. But if you have the talent to be in the major leagues as a pitcher and you tear your elbow ligament, we can say pretty conclusively there is a high rate of return to pitching at the previous level."
Erickson added that these players excelled because they did a
good job in physical rehabilitation before returning to the
"They rested and made sure they were healthy before they returned," he said.
For more about Tommy John surgery, visit
Oregon Health & Science University.
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