Your Premier Source for Tommy John Surgery in NYC

Brandon J. Erickson, MD June 5th, 2019

Why Rothman Orthopaedic Institute is the Best Choice for Tommy John Surgery in NYC

If Tommy John Surgery is in your future, it’s important to choose a medical team that puts the patient and their comfort as top priorities throughout every step of the process, has experience in athletes of all levels, and has been involved in research surrounding Tommy John Surgery. This team can be found at Rothman Orthopaedic Institute. Our Shoulder & Elbow and Sports Medicine specialists are unparalleled when it comes to innovation, research, and cutting-edge technology. They stay ahead of the curve when it comes to finding new and improved ways to treat their patients and have been involved in several research projects surrounding Tommy John surgery in collaboration with Major League Baseball.

Tommy John Surgery History

Tommy John surgery is the nickname for ulnar collateral ligament (UCL) reconstruction surgery. The surgery is named after a Major League Baseball pitcher who had the first recorded success of this procedure in 1974. Before then, a UCL tear spelled the end of an athletic career.

A UCL tear is an injury almost solely sustained by those that repeatedly throw overhead, like baseball pitchers and javelin throwers. Tommy John surgery is performed on athletes of all ages, but recently it’s been getting a lot of attention for being primarily performed on athletic youths. According to research presented by Dr. Erickson at the American Orthopaedic Society for Sports Medicine and published in the American Journal of Sports Medicine, athletic youths aged 15 to 19 years old made up 56.7% of all Tommy John surgeries performed in the U.S. between 2007-2011. What’s even more shocking? That rate is increasing on average 9.1% every year.

Another recent trend is coming to light though as a reason for a spike in youth-related Tommy John surgeries, and one that is considered potentially dangerous: Young athletes (and their parents) assuming that this surgery is the immediate answer to treating a UCL injury and ensuring a complete and successful recovery, as demonstrated by Tommy John who pitched 13 more seasons after his famed procedure. "Tommy John surgery is not something that should be performed unless there's a significant injury to the ligament and the athlete wants to continue to pitch/play at a high level,” warns the study’s lead author Dr. Brandon Erickson. Patients and their caretakers need to be aware that surgery is always a serious procedure and in many cases should not be chosen before more conservative treatment methods have been considered and attempted.

About the UCL Tear

Tommy John surgery focuses on repairing an unstable and/or torn UCL. The UCL (ulnar collateral ligament) is a ligament that runs on the inside of the elbow from the humerus (upper arm bone) to the ulna (one of the two bones in the forearm). This thicker ligament has two important jobs: to hold the elbow joint together and prevent dislocation. When an overhead throwing motion is made, the UCL is especially put under extreme stress to stabilize the elbow. It is the most commonly damaged ligament in throwers.

Given that this is such a specific injury that requires a specialized surgery, it is key to seek out a team that focuses on this condition. Rothman Orthopaedic Institute has various teams dedicated to specific parts of the body to ensure the most specialized treatment. There’s even a team dedicated to Sports Medicine, meaning they are well-versed in UCL tears and the Tommy John surgical treatment— and will know what treatment will be most effective for your particular case.

About the Tommy John Surgical Process

Most ligament tears cannot be stitched back together, so they will have to be reconstructed. There is a certain subset of patients in whom we can perform a UCL repair, but this is a minority of the patients. The torn ligament is replaced with a tissue graft (most often harvested from another tendon within your body).

The patient will have a block and be given light sedation while the 60-90 minute surgery takes place. There are various phases of the Tommy John surgical process:

  1. Harvesting the Graft
    The tissue graft will be harvested from another part of your body, or from a donor/cadaver. It is typically taken from a tendon in either the forearm (palmaris) or from one of the hamstrings.

  2. Exposing the Joint
    After the graft is harvested, the UCL is exposed. Great care is taken to protect a very important nerve around the elbow (ulnar nerve) while the UCL is exposed. Once this is exposed, and incision is made within the ligament to expose the joint and the area for the graft to be secured.

  3. Securing the Graft
    Two holes are drilled into the ulna bone while a blind ended socket is drilled into the humerus bone in order to attach the new tendon. The graft tendon is then threaded through the holes and secured by sutures.

In most cases, the patient will be able to go home the same day.

About the Tommy John Surgery Recovery Process

Each rehabilitation process will vary from patient-to-patient, but no matter what your plan is, it is crucial to carefully and accurately follow the program prescribed by the doctor in order to ensure a successful recovery. The Rothman Orthopaedic team works with the patient, as well as their therapist, coach, and other members of their care team to ensure the best possible outcome.

Rothman Orthopaedic Institute puts a special importance on providing comfort, education, and knowledge to their patients. The medical world and its jargon can be overwhelming to most, but our specialists make sure to clarify anything that our patients are confused or unsure about. It’s important that you are just as informed as our specialists, that way the treatment and rehabilitation processes can have the best chances at success.

For Tommy John surgery in NYC, Rothman Orthopaedic Institute is the clear choice. To schedule an appointment, click here or contact us at 1-800-321-9999.

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