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Half a century later, Tommy John surgery is still a game-changer

From 1974, there is a connection that links Tommy John and Dr. Frank Jobe to Justin Verlander and Bryce Harper, impacting numerous top players. Jobe reconstructed a torn ulnar collateral ligament in John’s left arm on Sept. 25, 1974, extending

By JAY COHEN (AP Baseball Writer)

GLENDALE, Ariz. (AP) — There is a connection from Tommy John and Dr. Frank Jobe in 1974 to Shohei Ohtani, Justin Verlander and Bryce Harper, tying together a growing number of baseball’s top stars, primarily on the mound, but also at the plate.

A procedure that altered everything.

Close to 50 years ago, on Sept. 25, 1974, Jobe repaired a torn ulnar collateral ligament in John’s left arm. It was a groundbreaking feat for Jobe and a second chance for John, who transitioned from a career-ending injury to 14 more years in the majors — and a namesake link to sports medicine that would endure well beyond his playing days.

Tommy John surgery.

“If it weren’t for a surgery like this, I wouldn’t still be standing here,” stated Chicago White Sox pitcher Michael Kopech. “It’s extended the length of my career.”

In conjunction with arthroscopic surgery and ACL reconstruction, Tommy John is among the most significant advancements in sports medicine over the last 50 years, according to Dr. Tim Kremchek, a longtime physician for the Cincinnati Reds.

“It has extended and saved numerous careers,” he stated. “Not only in baseball, but now for various other sports where we’re performing it for numerous other athletes, particularly overhead athletes. But regarding baseball, I believe it’s allowed us to witness some of the greatest players in the world continue playing for an extended period of time.”

The origins of the surgery can be traced to Jobe’s work at Rancho Los Amigos, a Southern California hospital, where doctors used tendon transfers to assist people with polio.

Jobe simply applied the same idea to John’s elbow. He extracted the palmaris longus tendon from John’s right arm, drilled four holes in his left elbow, and then utilized the tendon to replace the torn ligament.

“It wasn’t a new concept,” Jobe mentioned in July 2013, about seven months before he passed away. “It was just new for the elbow.”

The actual procedure mainly remains the same as the one Jobe performed in 1974. However, doctors have made enhancements in terms of safeguarding the ulnar nerve, along with preventing excessive scarring, placing the ligament in the correct position, and generating the appropriate tension.

The development of the procedure — along with the physical development of the players themselves — is evident in the results on the field.

Verlander earned the AL Cy Young Award in 2022, two years after undergoing Tommy John surgery. Kopech had the operation in 2018, and he averaged 95.2 mph on his fastball last season. Dodgers pitcher Tyler Glasnow had Tommy John in 2021, and he struck out 162 batters in a career-high 120 innings last year. Harper, who had the procedure in November 2022, returned to Philadelphia’s lineup in May.

Then, of course, there’s Ohtani, who received a record-breaking $700 million contract from the Los Angeles Dodgers within months of his second major elbow operation.

“In terms of dollars and cents, I believe there’s no doubt that Tommy John is the most valuable reconstructive procedure there is,” said Dr. Neal ElAttrache, the head team physician for the Dodgers and the NFL’s Los Angeles Rams.

After many successful Tommy John surgeries, from young players to professionals, the main challenge for athletes might be the long and repetitive rehabilitation process.

The arm that had the surgery is in a cast at an approximately 90-degree angle for about 10 days after the operation. After the cast is removed and the stitches are taken out, it takes months to regain the full range of motion. This all happens before the player starts throwing again on flat ground.

It usually takes at least a year for a major leaguer to come back to the majors.

Dodgers pitcher Tony Gonsolin, who had surgery on Sept. 1, recalled the very first day of throwing, saying, “It was like 30 throws, nice and easy, and just felt super foreign, like I’d never thrown before. Took some video on it, and they did not look pretty at all. Then I threw a couple days later and it felt much better.”

As Gonsolin goes through the process, he appreciates the opportunity brought by Tommy John — something that was not available to major leaguers before 1974.

“I think the evolution of the surgery and just the sheer medical breakthrough from it allows to extend people’s careers,” he said.

“It gives everybody a second opportunity.”

The surgery was a source of pride for Jobe later in life. ElAttrache recalled being at a dinner with his wife after the Baseball Hall of Fame honored Jobe and his work. He was seated at a table with Jobe, John and Hall of Fame pitcher Sandy Koufax — whose illustrious career ended at age 30 due to chronic elbow pain.

“Frank said, ‘Sandy, the only bittersweet part of this, I wish I would have been smart enough to think of this a few years earlier. You would have been pitching a lot longer,’” ElAttrache said.



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