UCL reconstruction is a surgical procedure commonly used to repair a torn ulnar collateral ligament (which is located inside the elbow) by replacing it with a tissue graft from the patient’s own body. This surgery aims to stabilize the elbow, reduce, or eliminate pain while restoring stability and normal range of motion. This surgery was introduced and originally performed by Frank Jobe, M.D., on baseball pitcher Tommy John in 1974 and is since referred to as Tommy John surgery. Today, UCL reconstruction has become a common procedure, helping professional and college athletes continue to compete in a range of sports.

The injury

The ulnar collateral ligament (UCL) is the most frequently injured ligament in throwers. Injuries of the UCL can range from minor damage and inflammation to a complete tear of the ligament. Athletes with this injury will immediately feel pain on the inside of the elbow, and experience decreased throwing velocity.

Although throwing injuries of the elbow appear more often in pitchers, they can be seen in any athlete who participates in repetitive overhand throwing.  Overhand throwing puts significant stress on the elbow joint. Unlike an acute injury such as what may occur from a fall or collision with another player, an overuse injury manifests slowly over time. In many cases, overuse injuries develop when an athletic movement is repeated suddenly and repeatedly during specific periods of play or practice. When these periods are so frequent that the body does not have enough time to rest and heal, the athlete is at greater risk of developing an overuse injury requiring ulnar collateral ligament reconstruction.

The surgery

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

To repair of UCL ligament it is necessary to rebuild the ligament to restore elbow strength and stability. During the procedure, the doctor replaces the torn ligament with a tissue graft from the patient. This graft acts as a scaffolding for a new ligament to grow on. Recovery will vary from patient to patient depending upon the procedure performed. When UCL reconstruction is performed, it may take 6 to 9 months or more to return to competitive throwing.


Recent research has focused on identifying risk factors for elbow injury and strategies for injury prevention. Results prove that with proper conditioning, technique, and recovery time throwing injuries in the elbow can be prevented. In the case of younger athletes, pitching guidelines regarding number of pitches per game and week, as well as type of pitches thrown, have been developed to protect children from injury.

SRO specialty-trained orthopedic surgeons have dedicated their practices to this specialized field of study. With their commitment to continuously advancing their knowledge about the newest procedures and techniques, our surgeons are some of the most highly skilled shoulder and elbow surgeons in the area.

Dr. Neema Pourtaheri specializes in shoulder and elbow issues including ulnar collateral ligament surgery. His practice focuses on arthroscopy, fracture care, joint replacement, and minimally invasive procedures and more. He also performs PRP and stem cell injections.  Learn more …


Information for this article provided in part by American Academy of Orthopaedic Surgeons – AAOS.