Ulnar collateral ligament (UCL) injuries are also known as the “Tommy John” injury. The UCL is a small ligament on the inner portion of the elbow that can be damaged due to repetitive overhead arm activities such as pitching and high-intensity throwing. This injury most commonly occurs in baseball players but can affect other overhead or impact athletes (gymnasts and wrestlers for example) as well. Some patients with minor UCL injuries can successfully rehab the injury without surgery, but for this who can’t or who have higher level injuries, surgery is often the most reliable option to get them back to their sport.
UCL reconstruction is the classic Tommy John surgery. This involves taking a tendon graft, typically from the forearm but sometimes from the knee, and augmenting the torn ligament. This has been a very reliable procedure and has been able to return a high number of overhead athletes back to their sport. The recovery time for this procedure is typically 9 months to a year to get back to unrestricted activity.
UCL repair is a newer procedure that aims to preserve and primarily fix the torn UCL without using a tendon graft. Instead of the graft, an implant known as an “internal brace” is used to protect the repair while it heals. While this procedure is newer than the reconstruction, the early results are very promising, especially for adolescent patients. The advantages of the repair are that the healing time is roughly cut in half and a tendon graft does not need to be harvested. In all cases, Dr. Pace will attempt a primary repair of the UCL. Only if the UCL is damaged too severely that repair is not possible, or if it is the patient’s preference, will he do a reconstruction as the index procedure.
Contact Lee Pace, MD at (860) 837-9220 now for appointment or answers to your questions.