Ulnar collateral ligament reconstruction

The surgery is performed to restore optimal function for repetitive elbow movements or specifically throwing ability, often extending the careers of professional athletes.

The initial operation, John's successful post-surgery career, and the relationship between the two men was the subject of a 2013 ESPN 30 for 30 documentary.

[1] The ulnar collateral ligament (UCL) can become stretched, frayed, or torn through the repetitive stress of the throwing motion.

The risk of injury to the UCL is believed to be extremely high, as the amount of stress through the structure approaches its ultimate tensile strength during a hard throw.

[4] Research into throwing injuries in young athletes has led to age-based recommendations for pitch limits.

[10] Holes to accommodate a replacement graft tendon are drilled in the ulna and humerus bones of the elbow.

[11] The procedure is performed on an outpatient basis allowing discharge the same day, with the arm in a splint to protect the repair for the first week.

[12] Early attempts at UCL repair yielded poor results and were largely abandoned until anchor fixation was improved in 2008.

[13] Over two decades preceding 2016, the number of UCLR surgeries increased threefold, a rate that was expected to continue to rise.