Autograft (UCL Tear)

Ligament repair or reconstruction, commonly known as “Tommy John surgery,” refers to a surgical procedure aimed at addressing damage to the ulnar collateral ligament (UCL) in the elbow. The UCL is a critical stabilizing ligament on the inner side of the elbow joint and is particularly important for athletes involved in overhead throwing sports, such as baseball pitchers.

When the UCL is significantly torn or damaged, it can lead to instability, pain, and reduced performance. Tommy John surgery is a well-established procedure commonly performed on athletes to address UCL injuries.

The surgical process typically involves the following steps:

  1. Evaluation: The orthopedic surgeon evaluates the extent of the injury using imaging studies such as MRI and assesses the individual’s overall elbow function and athletic demands.
  2. Incision: An incision is made in the inner side of the elbow to access the damaged UCL.
  3. UCL Repair: If the UCL injury is suitable for repair due to a partial tear or intact tissue, the surgeon may choose to directly repair the ligament by reattaching it to the bone using sutures or anchors.
  4. UCL Reconstruction: In cases of a complete UCL tear or insufficient ligament quality for repair, a reconstruction is performed using a graft from another tendon, typically the palmaris longus tendon from the forearm, hamstring tendon, or donor tissue.
  5. Graft Placement: The graft is woven through tunnels drilled in the humerus and ulna bones, providing stability and function similar to the original UCL.
  6. Closure: The incision is closed, and the arm is immobilized in a splint or brace to protect the repair or reconstructed UCL.

Recovery and Rehabilitation

Following Tommy John surgery, a comprehensive rehabilitation program is a crucial component of the treatment. The rehabilitation process typically progresses through specific phases, starting with immobilization and gradually incorporating range of motion exercises, strengthening activities, and sport-specific throwing drills.

The overall recovery timeline varies based on individual factors, the specific surgical technique, and the demands of the individual’s athletic endeavors. It generally takes around 12 to 18 months for an athlete to return to competitive throwing sports following Tommy John surgery.

It’s important for individuals undergoing Tommy John surgery to adhere to the prescribed rehabilitation protocol, comply with post-operative guidelines, and work closely with physical therapists, trainers, and healthcare providers to optimize outcomes and minimize the risk of re-injury.


This outpatient procedure requires a splint for 10 to 12 days, followed then by a hinged brace for an additional one to two weeks.  A structured physical therapy program is then carried out to restore elbow range of motion and strength.  In addition a focused rehabilitation of the leg, hip, abdominal, and back musculature allows optimal return.  Return to contact sports may take upwards of six months and return for the overhead or throwing athlete (baseball) may take upwards of eight months for position players and upwards of 12 months for pitchers.  Ulnar collateral ligament reconstruction allows a reliable return for overhead athletes or workers to their pre-injury level. 

Stories Related to Autograft (UCL Tear)

1 of 1
You are using an unsupported version of Internet Explorer. To ensure security, performance, and full functionality, please upgrade to an up-to-date browser.