AANA Elbow Arthroscopy - August 2024-UCL Injuries of the Throwing Elbow

UCL Injuries of the Throwing Elbow – The Tommy John Procedure

Video Transcription

Video Summary

This presentation reviews the evolution, indications, techniques, and outcomes of ulnar collateral ligament (UCL) injuries and their treatments, focusing on the "Tommy John" procedure. Initially pioneered by Dr. Frank Jobe in 1974, the traditional UCL reconstruction has seen modifications such as the Andrews modification, docking, and hybrid techniques, improving nerve management and surgical success. Surgical indications include complete or refractory partial UCL tears in competitive throwers, with a typical recovery of 12 months and an 84% return-to-sport rate. More recently, direct UCL repair augmented with an internal brace, popularized by Drs. Jeff Dugas and Buddy Savoy, has shown promising results, especially in select young athletes with partial tears, offering faster recovery (~6 months) and high return rates (~92%). Revision surgeries remain challenging with lower return rates but may benefit from newer repair and augmentation methods. Overall, the internal brace is gaining acceptance as a valuable adjunct that may become standard in future UCL surgeries.

Keywords

Ulnar Collateral Ligament

Tommy John Surgery

UCL Reconstruction Techniques

Internal Brace Augmentation

Sports Injury Recovery

Revision UCL Surgery