UCL Surgery: Recovery, Procedure & What To Expect

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UCL surgery, also known as Tommy John surgery, is a reconstructive procedure to repair a torn ulnar collateral ligament in the elbow. It's common among athletes, especially baseball players.

What is UCL Surgery?

The ulnar collateral ligament (UCL) is on the inside of your elbow. It connects the humerus (upper arm bone) to the ulna (one of the forearm bones). Throwing, especially overhead, can put a lot of stress on the UCL, leading to tears or damage over time. UCL surgery replaces the damaged ligament with a tendon from elsewhere in your body (autograft) or a donor (allograft).

Who Needs UCL Surgery?

  • Athletes involved in overhead throwing sports (baseball, softball, volleyball, javelin).
  • Individuals with elbow pain and instability that doesn't improve with conservative treatments (physical therapy, rest, medication).
  • Those diagnosed with a UCL tear through physical examination and imaging (MRI).

The UCL Surgery Procedure

  1. Anesthesia: You'll receive either general or regional anesthesia.
  2. Graft Harvesting: If using an autograft, the surgeon will remove a tendon from your forearm, hamstring, or foot.
  3. Ligament Reconstruction: The surgeon drills tunnels in the humerus and ulna, then weaves the graft tendon through these tunnels in a figure-eight pattern to recreate the UCL.
  4. Closure: The incision is closed with sutures or staples.

UCL Surgery Recovery

Recovery is a lengthy process, typically lasting 9-12 months or longer for athletes to return to their sport.

Initial Phase (0-6 weeks)

  • Elbow immobilization in a brace.
  • Pain and swelling management.
  • Gentle range-of-motion exercises.

Intermediate Phase (6 weeks - 4 months)

  • Gradual increase in range of motion and strength.
  • Physical therapy to restore elbow function.

Advanced Phase (4-9 months)

  • Sport-specific training (throwing program for baseball players).
  • Continued strengthening and conditioning.

Return to Sport (9+ months)

  • Gradual return to competitive play.
  • Close monitoring for any signs of reinjury.

Risks and Complications

  • Infection
  • Nerve damage (ulnar nerve)
  • Stiffness
  • Graft failure

Success Rates

UCL surgery has a high success rate, with many athletes returning to their pre-injury level of performance. However, success depends on factors like the severity of the injury, the athlete's commitment to rehabilitation, and the sport they play.

If you're experiencing elbow pain or suspect a UCL injury, consult with an orthopedic surgeon specializing in sports medicine to determine the best course of treatment. Early diagnosis and appropriate management can help you get back in the game.