Does your elbow have this problem too? Let's talk about Tommy John Surgery!

Are you a sportsperson who plays cricket, volleyball, or javelin throwers? Then you are probably familiar with the pain that comes from the inside of your elbow. This injury is very common in sports that involve throwing something with your arm. Sometimes this pain can be so severe that it can put an end to your sports career. Today we are talking about a special surgery that comes to the rescue at such times and has saved the future of many athletes. That is the "Tommy John surgery".

Simply put, what is Tommy John surgery?

It's very simple. Tommy John surgery is a surgery that repairs a special ligament in your elbow. Medically, we call this UCL surgery (Ulnar Collateral Ligament) replacement surgery .

Think of your elbow joint as a door hinge. There are straps on both sides of this hinge that hold it in place without moving around unnecessarily, right? Similarly, there is a strong band on the inside of the elbow that keeps the elbow joint stable, which we call the `(Ulnar Collateral Ligament)` or `(UCL)`.

Similarly, when throwing something with a lot of pressure on the arm repeatedly (especially fast bowlers in cricket, baseball players, javelin throwers), this `(UCL)` ligament can gradually become stretched, torn and damaged. This surgery is done to repair that damaged ligament.

So why is this called 'Tommy John'?

There is a very interesting story behind this. This surgery got its name from the famous American baseball player named Tommy John . He was a bowler. In 1974, this ``UCL`` ligament in his elbow was severely torn. At that time, it was something that could have ended his playing career. But the doctors performed a new operation and healed his elbow. After about a year of rest, Tommy John started playing again successfully. Since then, this surgery has been known as the "Tommy John surgery".

Do I really need this surgery?

This is a problem that many people face. If you are just a recreational athlete, you may be able to cure this condition by giving your elbow plenty of rest and other treatments.

However, if you are a competitive or professional athlete whose entire career depends on this throwing ability, this surgery may be essential for you. The main things expected from this surgery are:

• Stabilizing your elbow.
• Reducing pain.
• Restoring range of motion in the elbow.

During the surgery, your surgeon uses a healthy tendon from somewhere else in your body to replace the damaged UCL. This is called a graft. This graft is attached to the upper arm bone (humerus) and the forearm bone (ulna) to act like a new UCL.

How do you prepare before surgery?

Your doctor will explain everything you need to do before the surgery. Usually, you will need to do the following:

• A complete physical examination to see if you are healthy enough for surgery.
• Several blood tests .
• An imaging test, such as an X-ray , CT scan , or MRI scan , may be needed to clearly assess the condition of the elbow.
• An ECG test to check the functioning of the heart.
• A dental check-up to reduce the risk of infection after surgery.

Your doctor will advise you on how long you should stop eating and drinking the day before your surgery. Usually, you will need to stop eating and drinking about 12 hours before your surgery.

What happens during the surgery?

Before the surgery begins, an anesthesiologist will put you under general anesthesia so you won't feel any pain during the surgery.

The surgery usually takes place in these steps:

1. Looking inside the elbow: First, the surgeon can insert a small camera (arthroscopy) to check for other damage inside the elbow.

2. Obtaining the Graft: To create the new ligament, a 6-7 inch piece of healthy tendon is taken from somewhere else in your body. This is usually taken from your own forearm. Sometimes, a hamstring can also be taken from the back of your knee .

3. Cleaning: All damaged tissue inside the elbow is removed.

4. Bone preparation: Next, two holes are drilled in the forearm bone (ulna) and three holes are drilled in the Y-shaped part of the upper arm bone (humerus).

5. Inserting a new ligament: The previously removed tendon ``graft`` is passed through these holes and fixed as a new ligament. Small screws may be used to secure it to the bone.

6. Other repairs: If the ulnar nerve or other parts of the elbow have been damaged during this time, they will also be repaired.

7. End of surgery: Finally, the skin wound is sutured closed and covered with a clean bandage. After surgery, a splint is placed to prevent movement of the elbow.

This surgery usually takes between 60 and 90 minutes .

What are the benefits and risks of surgery?

Like any surgery, Tommy John surgery has its benefits as well as some risks.

How is the recovery after surgery?

Your doctor and physiotherapist will give you a recovery plan that is right for you. It may typically look like this:

When to see a doctor

If you experience any of these symptoms after surgery, you should call your doctor immediately .

• Chest pain
• Difficulty breathing
• Fever higher than 39 Celsius (102 Fahrenheit)
• Signs of infection such as bleeding or pus-like fluid from the surgical wound, swelling, foul odor, and an unusual feeling of warmth.
• New or worsening pain in the elbow, arm, or hand.
• The pain is so severe that it cannot be controlled even with painkillers.

Tommy John surgery is the most successful solution to a sports-ending injury in the past. Although the recovery time is long, with patience and following your doctor's instructions exactly, you can successfully return to the field of play. If you rush and start training before your doctor gives you the okay, you may have to undergo more surgeries and be away from sports for an even longer period of time. So patience is the key here.

Tommy John Surgery, UCL surgery, elbow pain, sports injuries, tendon surgery, ulnar collateral ligament