Tommy John

Ideal candidates for UCL reconstruction are athletes, especially baseball pitchers and other throwing athletes, who have a UCL injury causing pain, decreased performance, or elbow instability. This procedure is often recommended when non-surgical treatments like rest, physical therapy, injections, and anti-inflammatory medications have not improved symptoms.

The procedure starts with either general anesthesia so you are completely asleep during surgery. Then, your elbow surgeon Dr. Mayo prepares a graft to replace the torn UCL. The graft can be harvested from your own body, usually from the forearm or hamstring tendon, or from a deceased donor (allograft). An incision is then made over the inner elbow. Holes are drilled into the humerus and ulna, and the graft is threaded through these holes in a pattern that replicates the UCL’s original position. The graft is secured using screws or other fixation devices. Over time, the bone tunnels heal around the graft, integrating it into your joint.

Full recovery from Tommy John Surgery and a return to competitive sports typically takes between 12-18 months. This timeline allows the graft to heal fully and enables the athlete to complete a comprehensive rehabilitation program. For non-athletes or those with less physically demanding jobs, the return to work may occur a few weeks after surgery.

After surgery, your elbow will be immobilized in a splint or brace. Pain medication will be provided to manage discomfort. You will be monitored in a recovery room until the anesthesia wears off, and will be home on the same day.

Physical therapy is a crucial part of recovery. The rehabilitation program is typically broken into several stages:

• Early Stage (Weeks 1-6): Initial goals include reducing swelling, pain control, and preventing shoulder stiffness.
• Intermediate Stage (Weeks 6-12): The focus shifts to regaining full range of motion and beginning light strengthening exercises.
• Late Stage (Months 3-6): The emphasis here is on progressively increasing strength and starting sport-specific activities.
• Return to Sport (Months 6-12+): This phase involves advanced throwing programs and a gradual return to competitive play.

As with any surgical procedure, there are potential risks:

• Infection: This is rare and can usually be managed with antibiotics if it occurs.
• Nerve damage: There’s a small risk of temporary or permanent nerve damage in the arm.
• Graft failure: The new ligament may not heal properly, leading to continued elbow instability.
• Stiffness or loss of motion: Some patients may experience stiffness or a loss of motion in the elbow.
• Inability to return to play: Though the goal is to get your elbow functioning the same as it did before surgery, even with a well done surgery and proper rehab you may not be able to perform as well as you did prior to injury.

If you opt not to proceed with UCL reconstruction when it’s recommended, you may continue to experience elbow instability, pain, and a decrease in sports performance. Persistent stress on a damaged UCL could result in further damage, which may eventually necessitate more complex surgeries.