Public Perceptions of Tommy John Surgery

Abstract

Background: Reconstruction of the elbow ulnar collateral ligament, known as Tommy John surgery, is being performed with increasing frequency. Hypothesis: We hypothesized that the public's perception of Tommy John surgery may be incorrect with regard to the indications, operative technique, risks, recovery time, and benefits obtained from the procedure. Methods: A questionnaire was developed to measure an individual's perception of Tommy John surgery with regard to indications, operative technique, risks, recovery time, and overall benefits of the procedure. Questionnaires were given via a one-on-one interview or mailing after receiving prior consent. Questionnaires were completed by 189 players, 15 coaches, and 31 parents. Data were calculated and statistical analysis was performed. Results: Indications: Thirty percent of coaches, 37% of parents, 51% of high school athletes, and 26% of collegiate athletes believed that Tommy John surgery should be performed on players without elbow injury to enhance performance. Risk Factors: Thirty-one percent of coaches, 28% of players, and 25% of parents did not believe number of pitches thrown to be a risk factor, and 38% of coaches, 29% of players, and 25% of parents did not relate pitch type (eg, curve balls) with risk of injury. Benefits: Many players (28%) and coaches (20%) believed that performance would be enhanced beyond pre-injury level. Return to Play: Individuals underestimated the time required to return to competition. Twenty-four percent of players, 20% of coaches, and 44% of parents believed that return would occur in < 9 months. Conclusion: This study is the first of its kind to investigate public perception of Tommy John surgery and has identified an alarming percent of players, coaches, and parents with misperceptions. Efforts should be made in our communities to better educate players, coaches, and parents regarding elbow ulnar collateral ligament injury in youth baseball players.