title: Avoiding Tommy John Surgery: What Are the Alternatives?
abstract: The number of ulnar collateral ligament (UCL) reconstructions being performed has risen sharply in recent years, most notably in the young amateur athlete. While successful outcomes have been reported with reconstruction, the surgery and the associated rehabilitation timeline may be difficult for the nonelite athlete to incur. Return-to-play expectations, along with level of competition, should help guide surgeons in exploring management options. While reconstruction remains a mainstay, focused research exploring nonreconstructive options has expanded. This review discusses the clinical approach to those with UCL injury, including current support for rehabilitation, biologic strategies, and available repair or augmentation alternatives.
authors.affiliation: Department of Orthopaedic Surgery, Stanford University, Redwood City, California, USA.
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Rebolledo
authors.affiliation: American Sports Medicine Institute, Birmingham, Alabama, USA.
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Dugas
authors.affiliation: Department of Orthopaedic Surgery, University of Michigan Medical School, Ann Arbor, Michigan, USA.
authors.forename: Asheesh
authors.initials: A
authors.lastname: Bedi
authors.affiliation: Rothman Institute at Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Ciccotti
authors.affiliation: Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, New York, USA.
authors.forename: David W
authors.initials: DW
authors.lastname: Altchek
authors.affiliation: Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, New York, USA.
authors.forename: Joshua S
authors.initials: JS
authors.lastname: Dines
mesh_terms: D001484:Baseball / Q000293:injuries*; D001688:Biological Products / Q000627:therapeutic use; D000070637:Collateral Ligament, Ulnar / Q000293:injuries* / Q000601:surgery; D006801:Humans; D026741:Physical Therapy Modalities; D000068958:Return to Sport; D012307:Risk Factors; D000070638:Ulnar Collateral Ligament Reconstruction / Q000534:rehabilitation; D000092464:Elbow Injuries
chemical_list: D001688:Biological Products
keywords: baseball; biologic healing enhancement; elbow; rehabilitation