Understanding the Basics Behind Tommy John Surgery
What is Tommy John Surgery?
Baseball fans have likely heard about Tommy John surgery.
This is a common treatment for repairing a torn ulnar collateral ligament (UCL) in the elbow, an injury that plagues pitchers at all levels. But injuries to the UCL happen off the diamond, too.
Sports injuries, like UCL tears, are commonplace in today’s active world. Athletes of any kind can succumb to an elbow injury, especially in sports that involve heavy lifting or repetitive throwing. Tommy John surgery in Kansas City is an option for treating UCL tears in active people of all kinds.
After your initial examination with a KCOA physician, we will recommend the best treatment for your needs. Our practitioners provide the comprehensive care you need so you can return to the activities you enjoy.
Other indications that someone may need Tommy John treatment include:
- Reduced range of motion
- Completely immobile or “locked” joint
Kansas City Orthopedic Alliance Elbow Injuries Assessment
Assessing the Injury
Finding the right elbow treatment in Kansas City starts with an assessment.
You can think of elbow pain as a spectrum, with some instances being more severe than others. The KCOA orthopedic specialists always focus on each individual patient and their concerns before creating a treatment plan. Therefore, during your initial appointment, we will often ask questions such as:
Therefore, during your initial appointment, we will often ask questions such as:
The answers to these questions help shape the next steps of the assessment process and guide our physical examination. After a proper assessment, we often begin with a physical examination to help determine the origin point of your pain. In some cases, advanced testing may be required for a full diagnosis.
- Does your pain currently limit you or your activities?
- Has your pain progressed or worsened recently?
- Have you experienced any tingling or numbness in your arm or fingers that makes tasks difficult?
- Did you notice or hear a popping sound at the time of your injury?
- Have you noticed any change in your symptoms that has made it more challenging to function?
- What are your lifestyle goals?
- How has pain affected those goals?
Also called radiographs, an X-ray captures a picture of the elbow. Orthopedic physicians may order an X-ray to rule out the possibility of a fracture (broken bone), osteoarthritis, or other elbow-related conditions.
Magnetic Resonance Imaging (MRI)
MRI captures images of muscles, bones, and tendons to help provide information other tests can’t detail. During an MRI, you will lie on a table that slides into a tube-shaped scanner. The machine creates a magnetic field around you, using pulsed radio waves to form the MRI images of the body parts being examined. Injecting a specific dye into the joint prior to the MRI may provide improved visualization of a suspected UCL injury.
Establishing a Care Plan
Based on the results of your interview, examination, and imaging studies, you can expect a custom care plan catered specifically to you.
Many people believe it’s best to wait until pain becomes severe, leading them to “put off” or delay treatments like Tommy John surgery.
If you are in constant discomfort, have shooting or stabbing pains, have limited range of motion, or an inability to perform your daily activities, Tommy John surgery may be right for you.
New technologies allow patients with elbow pain to fully recover and enjoy the benefits of a more functional, pain-free lifestyle.
Prior to surgery, you will typically receive at least 2 phone calls:
- A hospital registration representative will call to gather insurance and other personal information.
- A registered nurse will call to review your health history and medication information.
Dependent on your health history, your physician may require:
- Pre-surgical laboratory tests
- Primary care clearance
Pre-operative instructions will vary depending on your physician and the location of your surgery. Always check with your physician prior to surgery.
Most physicians require that patients not eat or drink after midnight prior to surgery the next day.
Additionally, you will need a designated family member or friend to drive you home on the day you are released from the hospital. Surgical patients cannot drive themselves home.
Day of Surgery
If you schedule your surgery with a KCOA physician, you can expect the following on surgery day:
- A receptionist will check you in at the hospital registration desk.
- A nurse will take you back and prepare you for surgery. They will start an IV, prepare the surgical site, and review your medical history and medications.
- Your surgeon and anesthesiologist will visit with you prior to your operation.
- The surgical team will take you to the operation suite for surgery.
How it Works
Tommy John surgery is a procedure designed to repair UCL tears when non-surgical efforts have been exhausted. During a Tommy John Surgery in Kansas City, you will remain under general anesthesia A small incision is then made in the elbow to allow the surgeon to visualize the torn ligament. Typically a new ligament is harvested from somewhere else in the body or from a donor to serve as the new UCL.
When attaching the new tendon, the surgeon will create holes in the bones connected to by the UCL (the humerus and ulna). Then, they thread the graft tendon through the holes and secure it with either screws, sutures, or buttons.
This procedure is one that is constantly evolving with new techniques and technology. KCOA physicians are at the forefront of most new treatment options available for the repair of a Tommy John injury. This surgery comes with a relatively long recovery period of 9-12 months before athletes can safely return to action.
After your surgery, you will remain in the recovery room while our experienced clinical team monitors you, providing pain relief medication, if needed.
Tommy John surgery is typically performed as an outpatient procedure, though some people may need to stay overnight in the hospital for observation if there are any complications.
After surgery, we will secure your arm in a brace to protect the healing tissue and prevent inflammation.
Physical therapy usually begins the first week after surgery and continues until the patient regains full range of motion.
What to Expect
The length of recovery time varies by patient and the activities they are returning to.
Non-throwing athletes or patients who have suffered a UCL injury as the result of a trauma, may be fully recovered in 6 months. Throwing athletes may take 9-12 months or more to return to their sport.
We recommend regular exercise, eating a balanced diet, maintaining a healthy weight, and monitoring your blood sugar levels if you’re diabetic.
In doing so, you may reduce the amount of stress on your joints to slow down any potential degenerative process.
Common Signs and Symptoms of Elbow Injuries
With so many different parts working together in your elbow, there are many potential causes of elbow pain. And each of those causes has a unique set of symptoms.
UCL injuries often cause pain on the inside of your elbow. Patients may report hearing a “popping sound” or experience sharp pain during an acute injury. Injuries to the UCL can come from acute trauma after a fall from a height or if the joint bends the wrong way, but the most common cause of UCL damage is gradual stretching of the ligament over time from repeated significant forces across the elbow joint. Elite baseball pitchers typically suffer from this kind of joint stress, but other repetitive movements in activities like weight lifting can also cause UCL damage.
what causes elbow injuries?
Anatomy of the Elbow
The body has different kinds of joints, and they all face different challenges. The elbow is a complex joint that connects 3 different bones: the humerus (upper arm), ulna (pinky side forearm), and radius (thumb side forearm). Covering the surface where these bones meet is articular cartilage, a smooth substance that protects the joint by cushioning and absorbing forces.
On the inside and outside of this joint are ligaments that hold the elbow together and prevent dislocation. One of these ligaments is the UCL, a small ligament on the inner portion of the elbow that provides stability for the elbow joint.
Surgery, even when minimally invasive like elbow arthroscopy, isn’t necessarily the first choice. Kansas City Orthopedic Alliance physicians prefer a more conservative approach to treatment, so we will typically exhaust all non-surgical options before recommending surgery. Non-surgical treatments for shoulder injuries include:
Movement can actually reduce pain and encourage healing in the elbow, as movement increases circulation in the joint, supplying oxygen and other nutrients that support joint health and function.
Your doctor may recommend over-the-counter NSAIDs (Non-steroidal anti-inflammatory drugs, such as Advil) or prescription medications. Especially with NSAIDs, you should always talk to your doctor to ensure they are the right treatment for you.
Cortisone injections can help reduce inflammation, and the effects tend to last for 3 to 6 months before you might need another one. Many people manage their pain with injections and physical therapy.
Regenerative medicines like stem cell injections or platelet-rich plasma can help nourish worn or damaged tissue. This option works best if you have mild-to-moderate elbow pain.
Frequently Asked Questions
Kansas City Orthopedic Alliance can get you back in the game.
Our care is personal. Our team is knowledgeable. And we’re more available than ever.
With access to board-certified specialists across Kansas City, we have the tools to meet almost every musculoskeletal condition.
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This place is amazing! I cannot say enough good things about our experience here! From the reception desk where they were beyond helpful and even made phone calls for me to my kids pediatrician to very short wait time then the patience and help of doctors and staff that were great with my 3 year old! Getting same day service this great was so nice! Love this place and highly recommend!!
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