Tommy John Surgery: Major Surgery

Laser eye surgery has become a pretty routine procedure. Nothing’s yet been perfected, and fear comes from a machine slicing your eyes open, but patients are in and out in practically no time at all, and the risk of complications is incredibly low. And many of those complications are minor and/or temporary. It’s a safe and accepted part of contemporary living. Given that it involves removing tissue from one body part and weaving it into another, it’s something of a miracle that Tommy John surgery these days has a success rate even within sniffing distance of laser eye surgery. Of course, it’s not that automatic, and of course, there’s still the year-long rehab, but Tommy John surgery isn’t feared the way it used to be, and the results tend to speak for themselves. Certainly, among fans, it seems like the operation is simply seen as a year-long delay. Less devastating, more annoying.

To an extent, that’s justified. Surgeons know what they’re doing, the rehab track has been tested a million times over, and most pitchers are able to make it back and make it back effectively within the usual timetable. Sometimes they even feel stronger, perhaps because other parts of their bodies are able to heal while the pitcher isn’t throwing. But it’s important to understand that there can be speed bumps. Sometimes there can be even bigger obstacles. Recovery from Tommy John shouldn’t be taken for granted, and you could just ask Cory Luebke.

Ever so quietly, Luebke went about establishing himself as one of the more promising starting pitchers in the National League. He started 17 times for the Padres in 2011 and allowed 39 runs, with four strikeouts for every walk. He came out in April 2012 pitching similarly well. At the end of that same month, he underwent Tommy John surgery.

As usual, it was expected that Luebke would be able to return early in the 2013 regular season. What actually happened was that Luebke made zero appearances. He experienced several setbacks during his effort to get back to the mound, and just the other day, it was announced that Luebke needs Tommy John surgery again. The Padres expect him to take about a year, again. They feel pretty confident in the timetable, just like last time.

The Luebke situation has been a disappointing mess, but it also hasn’t been an isolated event. Anecdotally, it feels like we’ve seen a greater number of pitchers than usual struggle during their Tommy John rehabs of late. It doesn’t mean the surgery has somehow gotten more dangerous or less effective, but Luebke isn’t the only reminder that ligament replacement surgery is still a pretty big deal.

Last summer, Daniel Hudson was working his way back from Tommy John surgery. He was sent out on a rehab assignment, and shortly before he was brought back by the Diamondbacks, he came down with some elbow stiffness. Examinations revealed that Hudson needed another Tommy John surgery, having re-torn his ligament. He’s on the way back again.

Brandon Beachy was incredible. Remember Brandon Beachy? He had Tommy John surgery in the middle of 2012. He managed to return to the Braves on time with little particular difficulty, and he turned in a few decent starts, but then his elbow started barking and he had to be shut down. He underwent an arthroscopic procedure for cleanup purposes, and now he’s looking to be healthy for spring training.

There’s Scott Baker, who had Tommy John surgery in March of 2012. Last offseason, the Cubs signed him to a one-year contract in the hopes that he’d bounce back and they’d be able to flip him for prospects around the deadline. That isn’t what happened. Instead, Baker experienced setback after setback, and he made his 2013 debut in September, throwing with diminished velocity.

Ryan Madson was a similar kind of case. He had Tommy John surgery at the end of March 2012. Last offseason, the Angels signed him to a one-year contract, in the hopes that he’d bounce back and be able to help a competitive team’s bullpen. That isn’t what happened. Instead, Madson experienced setback after setback, and he was released in August having not appeared in the bigs. He’s throwing now, looking for an employer.

It doesn’t end there. Joel Zumaya hasn’t been heard from since Tommy John surgery early in 2012. Joey Devine also hasn’t been heard from since Tommy John surgery early in 2012. Felipe Paulino had issues returning to the mound, although there were complications with his back and shoulder that might have been unrelated to what happened with his elbow. But the common thread is that a bunch of guys had Tommy John surgery and they’re still today looking to get back to what they were. Not one of these pitchers followed the timetable that we’re so happy to just take for granted. Of course everyone’s always warned that there can be issues and delays, but it seems like the actual probabilities aren’t sufficiently appreciated.

Tommy John surgery isn’t shoulder labrum surgery, and the surgeons who perform it know the procedure like the backs of their hands. But it’s not just a 12-month delay, even if that’s maybe the most usual outcome. There can be setbacks, and there can be major setbacks. Ligaments can be re-torn. Elbows can otherwise need to be re-opened. Of course it’s never good news when a pitcher requires ligament replacement surgery, but on top of the loss of a year, there can be a loss of a lot more than that.

I’ve got no idea how the pitchers above are going to do going forward. Many of them should return to the majors, and they could be successful if and when they’re ever healthy. The Braves will be counting on Beachy, and the Diamondbacks made a point of re-signing Hudson. The Mariners scooped Baker up and the Padres will look forward to having Luebke whenever that is. Maybe they’ll simply have missed a little more time. But in each case, recovery went awry, and it’s too easy to forget that that can happen.

Tommy John surgery was one of the most significant developments in baseball in the 20th century, and it’s helped to save so many virtually countless careers. It really has gotten to the point where a lot of fans simply take the procedure and the recovery for granted. That speaks volumes about the effectiveness of the operation and the people doing it, but ultimately, it’s still surgery, and it’s still pitching. Tommy John surgery is great. Elbows and shoulders suck.

Jeff made Lookout Landing a thing, but he does not still write there about the Mariners. He does write here, sometimes about the Mariners, but usually not.

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10 years ago

I think it is good to point out that Tommy John surgery is a significant surgery and recovery is not automatic, however I’d really prefer a comparison rate of successes to failure or delays. 8 recent failures/set backs sounds bad but how does that compare to the total number of surgeries done?

A. Lane
10 years ago
Reply to  Gricomet

Here is a good primer, which discusses success rates and complications.

10 years ago
Reply to  A. Lane

Thanks for linking this!! From TFA:

“According to both the short term and long term Dr. Andrews studies, 83% of pitchers return to play at the same level or higher. 83% is a really good result, but it is not 100%.”