Tommy John surgery
Tommy John surgery, more properly known as ulnar collateral ligament reconstruction (or UCL), is a surgical operation in which a ligament in the medial elbow is replaced with a tendon from elsewhere in the body (often from the forearm, hamstring, or foot of the patient). The procedure was developed by Dr. Frank Jobe in 1974 for pitcher Tommy John, for whom the surgery is named.
The injury results from repetitive use of the elbow during the violent motions involved with throwing a baseball. In the surgery the new tendon is implanted and woven in a figure-eight pattern through holes drilled in the humerus and ulna bones.
A torn elbow ligament was the most common cause of what was simply called "dead arm injury" during most of the 20th century.
At the time of the first operation, Jobe put John's odds at returning to pitch 1 in 100. After his 1974 surgery, John spent 18 months rehabilitating his arm, returning for the 1976 season. He would go on to pitch in the major leagues until 1989 at age 46. The chances of a complete recovery after the modern surgery are estimated at 85 to 90 percent. Rehabilitation takes around 12 to 15 months for pitchers and about 6 months for position players. At the time of Jobe's death, in the spring of 2014, it was reported that a third of major league pitchers had had the surgery. During the 2000s, an average of 16 major league pitchers underwent the procedure each year. There were then a record 36 such operations performed in 2012.
It is not uncommon for pitchers to throw harder after the surgery than they did before the injury. However, this results not because of the surgery itself, but from the rigorous rehabilitation that ensues following surgery. Another common myth is that the injury happens suddenly, the result of overuse one day or of plain bad luck; in fact tests performed on pitchers indicate that the ligament becomes frayed over years of abuse, starting in youth baseball, and eventually snaps.
Drs. Lewis Yocum and James Andrews are two other doctors who have commonly performed the surgery for professional baseball players. Masaharu Mitsui was the first Nippon Pro Baseball pitcher to undergo the surgery, doing so in 1979.
John Smoltz became the first pitcher to be elected to the Hall of Fame after undergoing the surgical procedure, when he was a first-ballot inductee in the 2015 Hall of Fame Election. He underwent the procedure in 2000, missed that season altogether, then returned as a closer for a few years, compiling over 150 saves, before finishing his career as a starting pitcher once again.
Tommy John Surgery Patients
Pitchers with three or more operations
- Chad Fox (several times)
- Jason Isringhausen (three times)
- Josh Johnson (three times)
- Jarrod Parker (three times)
- José Rijo (five times)
- Scott Williamson (several times)
- Roberto Alomar
- Rocco Baldelli
- Jay Buhner
- José Canseco (the injury was caused during a pitching appearance)
- Shin-Soo Choo
- Trace Coquillette
- Carl Crawford
- Ben Davis
- Rafael Furcal
- Craig Gentry
- Luis Gonzalez
- Rusty Greer
- José Guillén
- Brad Hawpe
- J.R. House
- Todd Hundley
- César Izturis
- Trey Lunsford
- Kelly Johnson
- Carlos Martínez
- Justin Maxwell
- Xavier Nady (twice)
- Ray Olmedo
- Jay Payton (twice)
- Miguel Sano
- Luke Scott
- Taylor Teagarden
- Matt Wieters
- Tony Womack
- Dirk Hayhurst: "Hard Truths: MLB needs a priority shift", Sports on Earth, May 15, 2014. 
- Bob Nightengale: "John Smoltz worries he may be last Tommy John pitcher in Hall of Fame", USA Today Sports, July 8, 2015. 
- Jorge L. Ortiz: "Tommy John surgery now 'an epidemic'", USA Today Sports, April 11, 2014. 
- Jorge L. Ortiz: "Tommy John solution? Pitch less, young man", USA Today Sports, May 29, 2014. 
- Jorge L. Ortiz: "Tommy John 2015: Two-time victims have brighter outlook", USA Today Sports, March 1, 2015. 
- Jeff Passan: The Arm: Inside the Billion-Dollar Mystery of the Most Valuable Commodity in Sports, HarperCollins Publishers, New York, NY, 2016. ISBN 9780062400369