'Tommy John' elbow reconstruction 95 percent successful with grown teen pitchers, study says

March 13, 2010

A new study presented today at the American Orthopaedic Society for Sports Medicine's (AOSSM) Specialty Day in New Orleans, (March 13), found that 95 percent of skeletally mature high school pitchers were satisfied with their "Tommy John" elbow reconstruction surgery. Almost as many, (94.7 percent) returned to competitive baseball.

"Tommy John" surgery is a procedure where a damaged elbow ligament (ulnar collateral ligament or UCL) is replaced with a tendon from elsewhere in the body. The surgery is named for Hall of Fame pitcher Tommy John, who was the first person to have the surgery in 1974. John returned to the major leagues and went on to win 164 games after the surgery. Prior to this historic surgery, a UCL injury was a career-ending injury.

"High school kids have been a grey zone for this surgery," said Michael J. Angel, MD, of Premier Orthopaedics of Westchester and Rockland. "Obviously, surgeons would avoid surgery on young patients whose growth plates had not closed. But this study can give surgeons the confidence to recommend this surgery to teenage skeletally mature athletes. It also gives the teen and their parents assurance that the surgery should go well."

In the study, 20 high school baseball pitchers between 16 - 18 years old had the UCL surgery, 19 out of 20 reported being satisfied with the surgery (17 were very satisfied, 2 were somewhat satisfied). Eighteen of the 19 satisfied patients (94.7 percent) reported that they returned to competitive baseball. Of the 19 players, three reported that their highest level of competition was in the minor leagues, another 13 went on to play intercollegiate baseball and three returned to high school baseball.

Overuse injuries account for nearly 50 percent of all sports injuries in middle school and high school students, according to the National Center for Sports Safety. For high school athletes whose growth plates have closed, this study shows that the "Tommy John" UCL reconstruction is a successful option for teenage baseball pitchers who need it.

While the trend of young athletes to specialize in one sport remains controversial, has developed innovative surgeries to repair and reconstruct overuse injuries that can result from specialization. However, the bigger problem is prevention of injury. AOSSM and several other sports medicine organizations, including the American Academy of Orthopaedic Surgeons, American Medical Society for Sports Medicine, American Academy of Pediatrics, National Athletic Trainers' Association, National Strength and Conditioning Association and SAFE Kids USA have teamed together to help prevent overuse injuries in youth athletes. The STOP (Sports Trauma and Overuse Prevention) Sports Injuries campaign includes cutting edge information on sport specific injury prevention techniques for athletes, parents, coaches and healthcare providers. For more details, visit www.STOPSportsInjuries.org.

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