Tommy John Surgery

Ulnar Collateral Ligament (UCL) Injuries of the Elbow

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Any sport that involves a throwing motion can lead to a tear in the ulnar collateral ligament -- a band of tough, flexible tissue that stabilizes the elbow joint. Besides baseball, that can include football, racquet sports, javelin, and volleyball. Symptoms of a torn or damaged UCL include pain on the inside of your elbow. You may also notice that your throw has less power. Tommy John surgery can treat this painful injury and eventually return you to the sport you love.

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About Tommy John Surgery

The Goal of Tommy John Surgery (UCL Reconstruction)
Tommy John surgery reconstructs a torn UCL. The goal is to stabilize the elbow, restore range of motion, and reduce pain. It may be recommended for athletes who frequently throw overhead or place significant stress on the inside part of the elbow.

More Younger Athletes Having Tommy John Surgery
In recent years, more young athletes have begun having this surgery. These younger players are especially vulnerable to injuring their elbows because their bones are still growing. They also often play sports year-round with little time for rest. Now, newer techniques are available for UCL repair in younger patients, which can significantly shorten the rehab time.

James R. Urbaniak, MD, Sports Sciences Institute

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Examination and Imaging

Your orthopaedic surgeon will ask about your symptoms and examine your elbow. You may have X-rays or an MRI to help identify your injury. 

Nonsurgical Treatment

Whenever possible, your doctor will first try nonsurgical treatments such as rest, physical therapy, or anti-inflammatory medicines. You may be a candidate for Tommy John surgery or UCL repair if nonsurgical methods don’t help.

Surgery and Rehab

Tommy John Surgery

Tommy John surgery, also called UCL reconstruction, involves replacing the torn ligament with a tissue graft that becomes a platform where new ligament tissue can grow. The graft is usually taken from one of your own healthy tendons, but it can also be cadaver tissue. 

UCL Repair

Surgery to repair the UCL may be an option for some younger patients who have torn the ligament directly off the bone of the humerus (upper arm) or the ulna (forearm). In these cases, if the UCL tissue is healthy, your surgeon can use a technique that preserves the UCL and significantly reduces the rehabilitation time.

Physical Therapy

After surgery, you’ll need physical therapy to help you restore your strength and movement. You also may wear a special brace for a while to protect your elbow. People who have Tommy John surgery can typically return to their sport. Complete recovery takes about 12 months.

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Why Choose Duke

Experience and Skill
Tommy John surgery is uncommon and very specialized. Your surgical team’s level of experience is an important factor in the success of the procedure. Duke surgeons perform multiple Tommy John surgeries and UCL repairs each year.

Specialized Physical Therapists
After your surgery, a physical therapist who specializes in elbow rehabilitation will work with you to help you restore your strength and movement. 

Best Orthopaedic Hospital in North Carolina

Where you receive your care matters. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our orthopaedics program is nationally ranked, and the highest-ranked program in North Carolina, according to U.S. News & World Report for 2024–2025.

This page was medically reviewed on 11/02/2020 by