Second ‘Tommy John’ Surgery Is No Win for Pitchers

TUESDAY, March 24, 2015 (HealthDay News) — Having a second elbow ligament reconstruction surgery appears to lower professional baseball pitchers’ performance and shorten their careers, a new study finds.

Researchers looked at 33 major league pitchers who had surgery twice to reconstruct a torn ulnar collateral ligament in their throwing arm — a procedure widely referred to as “Tommy John” surgery because he’s the first pitcher who had the surgery.

After the second UCL reconstruction, 65 percent of the pitchers returned to pitching at a major league level. They averaged three years or less at the major league level after the second procedure. The number of innings they pitched decreased by nearly half, according to the study. The number of pitches resulting in walks rose from 4.02 to 4.79 for every nine innings, and their wins and losses dropped in half following the second surgery.

The Henry Ford Hospital study was to be presented Tuesday at the American Academy of Orthopedic Surgeons annual meeting in Las Vegas. Findings presented at meetings are generally considered preliminary until they’ve been published in a peer-reviewed journal.

“Although a second surgery may not be career-ending, it appears to be career-limiting by virtue of a decreased workload and pitching productivity,” senior study author Dr. Vasilios Moutzouros, an orthopedic surgeon, said in a Henry Ford Health System news release.

“And for those who return to the major league level, they experience a mixed bag of performance levels. In several categories, their performance declines significantly,” he added.

An UCL injury is believed to be caused by overuse and excessive stress on the inner elbow, along with pitching velocity and joint motion, study co-author and orthopedic resident Dr. Robert Keller said in the news release.

“It’s possible that increased surveillance of pitch counts, a lesser pitching role or a lack of arm endurance after a second surgery may be contributing factor in performance and pitching workload,” Keller said.

More information

Read more about elbow injuries from the American Academy of Orthopaedic Surgeons.