When pitcher Tommy John injured the ulnar collateral ligament (UCL) in his throwing elbow, an injury of that severity could mean the end of a baseball career.
What happened next would change not only John’s career, but also the future of orthopedic sports medicine.
“Tommy John had an injury to the ulnar collateral ligament, which is the ligament on the inner side of the elbow, which is under a lot of stress when you’re throwing,” explained Dr. Andrew Green, Chief of the Shoulder and Elbow Center at University Orthopedics.
At the time, there was no established surgical treatment that could reliably allow a pitcher with a torn UCL to return to the mound. John and orthopedic surgeon Dr. Frank Jobe took a chance on what was then considered an experimental procedure: reconstructing the damaged ligament.
The surgery worked.
Following extensive rehabilitation, John returned to Major League Baseball and went on to pitch for many more years. In fact, as Dr. Green notes, John’s career after surgery was even more successful than it had been before the procedure.
But the impact extended far beyond one pitcher.
From Career-Ending Injury to Treatable Condition
John’s successful surgery helped physicians better understand the UCL, the stresses placed on it during throwing, how the ligament becomes injured, and how it can be surgically reconstructed.
“That first surgery led to this whole understanding of the ulnar collateral ligament — what its function is, how it functions, how it works, how it’s injured, and then how to work to reconstruct it with surgery,” Dr. Green said.
Over time, UCL reconstruction became an important treatment option for baseball players and other throwing athletes. According to Dr. Green, approximately one-third of Major League Baseball pitchers have undergone the surgery, with many having the procedure before reaching the majors, whether in high school, college, or the minor leagues.
The significance is difficult to overstate. An elbow injury that once could end a promising pitching career became one from which athletes could potentially recover and return to competition.
Dr. Green points to Hall of Fame pitcher Sandy Koufax as an example of how different baseball history might have been had the procedure existed earlier. Koufax retired at just 30 years old, in part because of persistent problems with his pitching elbow.
“If he had been a little bit younger, maybe he would’ve ended up having the surgery,” Dr. Green said.
A Legacy That Extends Beyond the Mound
Tommy John’s willingness to undergo an experimental operation ultimately gave his name to one of the most recognizable procedures in sports medicine.
More importantly, his experience helped open the door to decades of research, advances in surgical technique, and a better understanding of elbow injuries in throwing athletes.
What began as an attempt to save one pitcher’s career ultimately changed what was possible for countless athletes who followed.
About Dr. Andrew Green
Dr. Green is a fellowship-trained specialist in problems of the shoulder, elbow, and upper extremity. He is an internationally recognized expert in shoulder and elbow surgery and is certified by the American Board of Orthopaedic Surgery (www.ABOS.org) in Orthopaedic Surgery and Orthopaedic Sports Medicine. He is a member of the American Academy of Orthopaedic Surgeons, the American Orthopaedic Association, the American Shoulder and Elbow Surgeons, New England Shoulder and Elbow Surgeons, and the Orthopaedic Trauma Association. He has been recognized as a “Top Doctor” and is listed in the Guide to America’s Top Orthopedists, and Who’s Who in America.
Each year he evaluates more than one thousand new patients and performs over 400 arthroscopic, reconstructive, joint replacement, and trauma surgeries for a broad spectrum of shoulder and elbow disorders. Most commonly, he treats patients for rotator cuff disorders (impingement syndrome and tears), shoulder dislocations and instability, labral tears, arthritis, fractures and sports injuries, using minimally invasive arthroscopic techniques and both standard and reverse total shoulder replacement. Dr. Green is an attending surgeon at Rhode Island Hospital and The Miriam Hospital in Providence, Rhode Island, and a consultant at the Providence V.A. Medical Center.