Athlete who needs Tommy John surgery

While ulnar collateral ligament (UCL) reconstruction is the procedure’s medical name, many sports enthusiasts refer to the procedure as Tommy John surgery.  

The procedure gets its name froma Los Angeles Dodger starting pitcher who blew out his elbow in 1974. In order to continue playing, he agreed to be the guinea pig for a trial surgical procedure. Legendary surgeon Dr. Frank Jobe successfully performed the procedure, and Tommy John returned to the mound just two years later. 


Since the success of the initial surgery, the need for Tommy John surgery has only increased. From high school ball players to the major leagues, hundreds of baseball players have undergone the surgery. In fact, 473 Major League Baseball players have received the surgery since 1974.  


Though it is a widely-known surgery, the details are often unknown. Below we answer the most frequently asked questions about Tommy John surgery. 

FAQs about Tommy John surgery

What is Tommy John surgery? 

Basically, Tommy John surgery is the remedy for an overuse injury or “dead arm.” In Tommy John surgery, an orthopedic surgeon repairs the ulnar collateral ligament (UCL), which connects the humerus to the ulna and secures the elbow joint. The ligament is prone to tear after repeated overuse, such as pitching a baseball. The surgeon drills holes into the humerus and ulna, and then weaves a new tendon through them to stabilize the elbow. 

When is Tommy John surgery necessary?

An orthopedic recommends Tommy John surgery when a patient tears their UCL as a result of overuse and hopes to return to the activity that caused the tear. However, surgery is not always needed. Rest, ice, retiring from the movement that caused the injury, and rehab are also an option. 

What does Tommy John surgery involve?

In short, Tommy John surgery involves harvesting a tendon from the patient’s body (or a donor) and attaching it to serve as the new UCL.  The harvested tendon, or graft, can be taken from various tendons in the body. Tommy John surgery is usually a 60-90 minute outpatient procedure performed under general anesthesia. 

What risks and complications are involved?

With most surgeries, there are risks of infection and issues related to anesthesia. Other common complications include nerve or blood vessel damage, stretching or rupture of the graft, and ulnar nerve irritation. 

How long does it take to recover from Tommy John surgery? 

Following Tommy John surgery,  it typically takes athletes a minimum of 9 months to a year to return to their prior performance level. Recovery involves a period of healing in which the elbow is braced followed by extensive physical therapy and rehabilitation. According to John Hopkins Medicine, most patients regain their normal range of motion in the elbow in two to four months following surgery. 

What is the success rate of Tommy John surgery?

Boston Children’s Hospital reported that the success rate of Tommy John surgery is 80 to 90 percent. Similarly, The American Journal of Sports Medicine conducted a study on a total of 179 pitchers who underwent Tommy John surgery. The study found that 148 pitchers (83%) returned to pitching (RTP)in the MLB, 174 pitchers were able to RTP in the MLB and minor league combined (97.2%), with only 5 pitchers (2.8%) unable to RTP to either the MLB or minor league.

Learn more about orthopedic surgical services at UAB Medical West


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