"Tommy John surgery" is named after the former major league pitcher who underwent the first successful UCL reconstruction in 1974. Today, UCL reconstruction has become a common procedure. Though a return to play is not guaranteed, the procedure has helped professional and college athletes continue to compete in a range of sports.

Who Needs It

Athletes who have an unstable or torn UCL, and who do not respond to nonsurgical treatment, are candidates for surgical ligament reconstruction.

How Does It Work

Most ligament tears cannot be sutured (stitched) back together. To surgically repair the UCL and restore elbow strength and stability, the ligament must be reconstructed. During the procedure, the doctor replaces the torn ligament with a tissue graft. This graft acts as a scaffolding for a new ligament to grow on. In most cases of UCL injury, the ligament can be reconstructed using one of the patient's own tendons.

In some cases, if the ligament is in good condition but is torn at the bony attachment, it can be reattached to the arm, eliminating the need for a graft. sometimes, the ligament is reinforced with a high-strength suture to add to the strength of the construct and potentially allow for a quicker return to play.


While athletes can often return to throwing in 6 to 9 weeks if a non-surgical procedure is successful, recovery may take much longer, if surgical intervention is required. On average it may take the athlete 6 to 9 months or more to return to competitive throwing after UCL reconstruction.