An ulnar collateral ligament (UCL) reconstruction is a type of surgery that is frequently performed to repair a ruptured UCL within the elbow by replacing it with a tendon taken from another part of the body.
The purpose of the procedure is to stabilize the elbow, lessen or get rid of the pain, and restore the range of motion as well as stability. Tommy John, a baseball pitcher, was the first patient to have this technique when it was first introduced and done in 1974 by Frank Jobe, M.D., hence the procedure’s common name, Tommy John surgery.
Michael’s Elbow Surgery Story
How Tommy John Surgery WorksUsually performed as an outpatient treatment, Tommy John surgery. This implies that you may typically make it home the same day. It can take anywhere between 60 and 90 minutes to complete, and general anesthesia is used.
Harvesting the Graft
Graft refers to the tendon used to repair the damaged UCL. It may come from different body parts of you or from a donor. Typically, a graft is obtained from one of the tendons listed below:
- Palmaris longus tendon from the forearm
- Hamstring tendon
- Big toe extensor tendon
Cleaning Out the Joint
A three to four-inch incision is created on the outside of your elbow to gain access to the elbow joint. Your surgeon can evaluate the damage after muscles and other tissues have been moved out of the way. Any harmed tissues are eliminated. In order to strengthen the structure, the surgeon will occasionally sew the remaining pieces of the original ligament to the graft.
Securing the Graft Inside the Elbow
Holes are bored in the upper arm bone (humerus) and lower arm bone (ulna), which the UCL originally joined, to attach the replacement tendon. These holes are then used to thread the graft tendon, which is then fastened with sutures, buttons, or screws.
Here is a tweet about the Tommy John surgery. You can see below:
The tendon can be threaded through the bones using a variety of methods. The figure-eight technique and the docking technique are the two most popular. Researchers are also creating brand-new, less invasive methods.
Jacob deGrom will undergo Tommy John surgery, per @Evan_P_Grant pic.twitter.com/5fN3Dm3sNN
— Talkin’ Baseball (@TalkinBaseball_) June 6, 2023
Who benefits from Tommy John’s Surgery?
Instead of a single traumatic event, Tommy Johns’s Surgery is often done for UCL rips that occurred from overuse. Baseball pitchers and other sportsmen who bend their elbows frequently are prone to these overuse problems. If your lifestyle or job places a lot of stress on your elbow, or if nonsurgical treatments don’t help reduce your pain, Tommy John surgery may be advised.
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Tommy John Risks
UCL restoration, like most procedures, carries infection and anesthetic risks. This technique may injure nerves or blood vessels. Numbness and weakness may result from this damage.
Grafts might stretch or rupture. Reconstruction with a new graft may be possible. Graft harvesting site problems are infrequent and treatable with medicine.
Elbow injuries can also irritate the ulnar nerve. The ulnar nerve goes around the elbow joint and the UCL is on the inner elbow. To avoid irritation, move it in front of the elbow.
Rehabilitation After Tommy John’s Surgery
Tommy John’s recovery usually comprises three phases. Tissue healing speed determines phase length.
- Right after the surgery, the elbow is secured in a brace at a 60- to 90-degree angle. The goal is to protect the healing tissue and reduce inflammation. You can start physical therapy right away, focusing on your wrist, fingers, shoulder, and biceps to help avoid muscle atrophy.
- One or two weeks after the surgery, you can start moving your elbow joint. Your doctor may put you in a hinged brace that can be locked at a certain angle when you are not exercising. You can also wear an arm sling for comfort. Physical therapy at this stage focuses on gradually increasing your range of motion in the elbow.
- By the end of the first month, you may be able to fully extend your elbow and eventually stop wearing the brace. With regular physical therapy, most patients regain their normal range of motion in the elbow in two to four months after the surgery.
Athletes may need lengthier rehabilitation. After Tommy John’s surgery, throwing athletes can usually return to competition in six to nine months. Maintain a rigorous strengthening and stretching regimen during and after sport. Athletes usually return to competition after nine to 12 months.
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