APEX Elbow Mastering Surgical Techniques for Clinical Success-UCL Injuries of the Throwing Elbow

UCL Injuries of the Throwing Elbow – The Tommy John Procedure

Video Transcription

Video Summary

This presentation covers collateral ligament injuries of the throwing elbow and Tommy John's procedure for UCL reconstruction. Originating with Frank Jobe in 1974, the surgery has evolved through various techniques, including modifications by Andrews and Olchek. Surgical indications include complete or refractory partial UCL tears, especially in athletes with a future in baseball. The speaker shares extensive experience with over 1,200 reconstructions, noting an 84% return-to-play rate. More recently, internal brace augmentation developed by Jeff Dugas enhances repair strength, allowing some patients to return to sport in under seven months. Direct UCL repair with internal brace shows promising results, especially in younger athletes with partial tears and good tissue quality. Revision surgeries are challenging with lower success rates and longer recovery, but newer hybrid repair techniques with internal brace offer hope. Overall, Tommy John's reconstruction remains the gold standard, but future procedures will likely incorporate internal brace augmentation to improve outcomes and healing.

Asset Caption

James R. Andrews, MD

Keywords

collateral ligament injuries

throwing elbow

Tommy John's procedure

UCL reconstruction

internal brace augmentation

return-to-play rate