What is Tommy John Surgery?
Tommy John Surgery, also known as Ulnar Collateral Ligament (UCL) Repair, is a surgical treatment where a torn ulnar collateral ligament is replaced with healthy tissue to restore full stability and function to the elbow. This procedure typically involves the reconstruction of the ulnar collateral ligament using a ligament from the patient’s leg or forearm. The goal of this procedure is to restore elbow stability function to allow patients to return to their favorite physical activities and is most commonly performed for throwing athletes, such as baseball pitchers. Dr. Joseph Lamplot, orthopedic elbow surgeon, treats patients in Arlington Heights, Kildeer, Lake Zurich, Barrington, and the surrounding Northwest Suburbs of Chicago, IL, who have a throwing injury and need Tommy John Surgery or an Ulnar Collateral Ligament (UCL) repair.
Who is most likely to need Tommy John Surgery or an Ulnar Collateral Ligament (UCL) repair?
Ulnar collateral ligament injuries are often seen in patients who perform frequent forceful throwing motions or repetitive overhead movements. Athletes who play overhead throwing sports such as baseball, softball, or volleyball are at a greater risk of developing a UCL injury that requires surgical repair or reconstruction due to the nature of their sport. Some UCL injuries can be resolved with nonsurgical approaches such as physical therapy, bracing, medications, or injections. However, if a patient has experienced a tear or has not had success with other conservative treatments, Tommy John Surgery may be recommended.
How is Tommy John Surgery done?
Tommy John Surgery is performed through a relatively small incision on the inside part of the elbow. During this procedure, Dr. Lamplot will usually first harvest a tissue graft from the patient’s forearm (palmaris longus tendon) or leg (gracillis tendon). In certain cases, a tissue graft is not needed, and Dr. Lamplot will perform a repair of the ligament with sutures and a specialized implant called an Internal Brace. If using a tissue graft, Dr. Lamplot will secure the graft by drilling small holes into the upper arm bone (humerus) and one of the forearm bones (ulna). This component of Tommy John Surgery allows for the tissue graft to take the place of the damaged ulnar collateral ligament. The tissue graft is then secured with strong surgical sutures. Typically, Tommy John Surgery is performed in about an hour, and patients can return home following the completion of the surgery.
Does Dr. Lamplot do Tommy John surgery with an Internal Brace?
This question comes up often, especially with collegiate and professional athletes. As mentioned above, yes, Dr. Lamplot will perform UCL repair with an Internal Brace for appropriate candidates following a discussion of the risks and benefits of this technique. The Internal Brace technique utilizes a strong surgical suture to reinforce a repair of the injured ligament rather than replacing the ligament as is done during a UCL reconstruction. The Internal Brace technique tends to be most successful when there is an avulsion tear (where the tendon pulls directly off the bone). The addition of the Internal Brace protects the healing ligament and has been shown to allow faster rehabilitation and return to sport with similar outcomes as UCL reconstruction.
What is an Internal Brace in Tommy John surgery?
The Internal Brace technique utilizes a very strong surgical suture called FiberTape which is attached to two suture anchors that are inserted into the bones at each end of the torn UCL ligament, allowing the repaired ligament to heal while adding support. The Internal Brace (below) is made by a company called Arthrex and looks a lot like a shoelace. It is a flat, braided, ultra-high-molecular-weight polyethylene, bovine-collagen-dipped version of a typically round super suture.
InternalBrace™ by Arthrex
How long does it take to recover after UCL repair or Tommy John Surgery?
Immediately following Ulnar Collateral Ligament (UCL) Repair, patients will be required to wear an elbow splint for approximately 1 week. After this time, the patient will be placed into a specialized elbow brace and encouraged to participate in exercises under the supervision of a throwing physical therapist with a focus on restoring range of motion. Activities must be modified for approximately 6 months after surgery to ensure the tissue graft or repair is allowed to heal properly. Most patients will be able to begin more intensive physical therapy at this time, including a progressive throwing program to improve strength and range of motion. Full recovery is seen in most non-pitching patients at about 9 months after surgery. Patients who are pitchers will typically see a full return to unmodified activities, including pitching, after approximately 12 months. Return to sport may be sooner with ligament repair than a tendon graft procedure. Dr. Lamplot will discuss with each patient which option is better for them based on the type of injury and athlete-specific goals. While most patients follow this timeline, recovery time can vary based on the severity of the initial injury and the patient’s compliance with physical therapy and rehabilitation protocols.
UCL Tear Surgeon – Tommy John Specialist
If you participate in throwing sports, like baseball, softball or volleyball, you are at risk of injuring the UCL in your elbow. Ulnar Collateral Ligament surgery is often referred to as Tommy John Surgery. UCL injury specialists, Doctor Joseph D. Lamplot, provides diagnosis as well as surgical and nonsurgical treatment options, including the internal brace, for patients in Arlington Heights, Kildeer, Lake Zurich, Barrington, and the surrounding Northwest Suburbs of Chicago, IL who have suffered a UCL elbow injury. Contact Dr. Lamplot’s team today!
