question about Tommy John surgery

“Tommy John surgery, known in medical practice as ulnar collateral ligament (UCL) reconstruction, is a surgical graft procedure in which a ligament in the medial elbow is replaced with a tendon from elsewhere in the body (often from the forearm, hamstring, hip, knee, or foot of the patient).”

When you remove a tendon from some area of the body, does not that make that area weaker than before?


Can this surgery be performed (if it is as customary) on other ligaments apart from the (famous) elbow area?

In reconstruction of the anterior cruciate ligament in the knee, a piece of hamstring or patellar is frequently used.

Depends on which tendon you use and how you harvest it. The short answer is while there’s usually a theoretical loss of strength, it’s not something you generally notice. Even losing something as insignificant as your palmaris results in a trivial loss of wrist flexion, for example, but in practice it’s not really noticable.

Well… Tommy John surgery refers specifically to elbow UCL reconstruction. But tendons are used to reconstruct ligaments all the time. There are literally hundreds of different ways to reconstruct an ACL, for example, many of which use harvested tendon as a replacement for a ligament, though conceptually that surgery is very different than Tommy John sugary. Reconstruction of a thumb UCL is very similar to elbow UCL reconstruction.

When I ripped my Achille’s tendon from the calcaneus a few years ago (no bone was involved), the tendon was sewed back on with the help of a titanium screw, but, in addition, my hallucis longus brevis was surgically cut and sewed to the Achilles’ tendon for further support. I asked the orthopedist if that would impair my ability to push off my big toe. After replying that in my case it wouldn’t matter :slight_smile: he said that other tendons can take over that duty.