Avoiding Tommy John Surgery: What Are the Alternatives?

Am J Sports Med. 2017 Nov;45(13):3143-3148. doi: 10.1177/0363546517692548. Epub 2017 Mar 9.

Abstract

The number of ulnar collateral ligament (UCL) reconstructions being performed has risen sharply in recent years, most notably in the young amateur athlete. While successful outcomes have been reported with reconstruction, the surgery and the associated rehabilitation timeline may be difficult for the nonelite athlete to incur. Return-to-play expectations, along with level of competition, should help guide surgeons in exploring management options. While reconstruction remains a mainstay, focused research exploring nonreconstructive options has expanded. This review discusses the clinical approach to those with UCL injury, including current support for rehabilitation, biologic strategies, and available repair or augmentation alternatives.

Keywords: baseball; biologic healing enhancement; elbow; rehabilitation.

Publication types

  • Review

MeSH terms

  • Baseball / injuries*
  • Biological Products / therapeutic use
  • Collateral Ligament, Ulnar / injuries*
  • Collateral Ligament, Ulnar / surgery
  • Elbow Injuries
  • Humans
  • Physical Therapy Modalities
  • Return to Sport
  • Risk Factors
  • Ulnar Collateral Ligament Reconstruction* / rehabilitation

Substances

  • Biological Products