UCL reconstruction is a surgery commonly used to repair a torn ulnar collateral ligament inside the elbow by replacing it with a tendon from elsewhere in the body. The goal of the surgery is to stabilize the elbow, reduce or eliminate pain and restore stability and range of motion. This procedure was introduced and first performed by Frank Jobe, M.D., on baseball pitcher Tommy John in 1974—hence the colloquial name Tommy John surgery.

After Michael Perry severely injured muscles and ligaments in his elbow as an offensive lineman for the University of Chicago, he returned to his hometown to be treated by elbow specialist Jack Ingari, M.D .

How Tommy John Surgery Works

Tommy John Surgery is typically an outpatient procedure. This means you can usually return home the same day. It is performed under general anesthesia and may last anywhere from 60 to 90 minutes.

Harvesting the Graft

The tendon used to replace the torn UCL is called a graft. It can be harvested from various parts of your body or from a donor. A graft is typically taken from one of the following tendons:

Palmaris longus tendon from the forearm

Hamstring tendon

Big toe extensor tendon

Cleaning Out the Joint

To access the elbow joint, a three- to four-inch incision is made on the outside of your elbow. Once muscles and other tissues are moved out of the way, your surgeon can assess the damage. Any damaged tissues are removed. Sometimes the surgeon will attach the remnants of the original ligament to the graft, reinforcing the structure.

Securing the Graft Inside the Elbow

To attach the new tendon, holes are drilled in the two bones originally connected by the UCL: the upper arm bone (humerus) and the lower arm bone (ulna). Next, the graft tendon is threaded through these holes and secured by sutures, buttons or screws.

There are several techniques of threading the tendon through the bones. The most common ones are the docking technique and the figure-eight technique. New, less invasive techniques are also being developed by researchers.