On September 25th, 1974, a founding member of the Kerlan-Jobe Orthopaedic Clinic, Dr. Frank Jobe, performed a surgery he thought might have a 1% chance of success. His patient, Tommy John, was a pitcher for the Los Angeles Dodgers who had suffered what, before that moment, what had been long-considered a career-ending injury for pitchers: an ulnar collateral ligament (UCL) tear.
Fast forward to 2024, at some point in their playing careers, over thirty percent of pitchers on Major League team rosters, have undergone the surgical procedure that Dr. Jobe pioneered in 1974. Currently, upwards of 9 out of 10 athletes have returned to play at or above their level with some adding numerous years of post-surgical play to their careers.
The orthopaedic surgeons of the Cedars Sinai Kerlan-Jobe institute have built on Frank Jobe’s legacy, becoming recognized as experts in this surgery, and performing dozens of successful Tommy John surgeries on MLB pitchers, as well as hundreds of minor league, college and even youth athletes. Today, they are recognized as a premiere destination for Tommy John surgery, and orthopaedic sports medicine.
Dr. Jobe’s surgical technique was phenomenal, but his odds were off. Today, it’s estimated that an athlete undergoing Tommy John surgery has not a 1% chance of returning to play, but averaging around 90% chance of getting back to the field at the same level they previously played.
The First Tommy John Surgery — 1974
I can describe the pitch vividly. It was July 17th, 1974. We were playing the Montreal Expos. I had a four nothing lead. I threw the pitch, and heard this banging sound in my elbow and felt this sharp pain.
Tommy John, 1979
Before 1974, a ruptured UCL signaled the end of a pitcher’s career. Although Los Angeles Dodgers’ pitcher Tommy John already had a respectable, 12-year career in the major leagues, like many pitchers, he suffered from elbow pain that never really went away.
“I first hurt my elbow at 13, going from little league [pitching] distance to major league distance,” said John.
Through John’s development in minor leagues, he kept having elbow problems, always in the same place, at the tip of his ulna. As his career progressed through the minors, and into the major leagues with the Cleveland Indians, Chicago White Sox and then Los Angeles Dodgers, Tommy John experienced the same persistent elbow pain that many other pitchers experienced.
But on July 17th of 1974, he experienced something much worse in the middle of a pitch. A pain like John had “never experienced before.” After 2 errant pitches, John walked off the mound for what he feared could be the last time – and what was confirmed as a UCL tear.
Dr. Jobe and Dr. Kerlan | Jon SooHoo © LA Dodgers, LLC 1988
Taking a Chance on the Unproven
Usually, said Dr. Jobe in a 2013 interview, when a player would get an injury like that “we’d tell them to try to get a good job when they got home.” But John had different ideas. He told his surgeon, “I want you to fix it.”
Tendon transfers had been used before, but they’d never been used in this application. When Dr. Jobe devised the procedure, he was up front with his friend about its chances of success. “Probably one in 100.”
But, said Dr. Jobe, “if you don’t have the surgery, you’ll never pitch major league baseball again.”
Those odds were good enough for Tommy John, so on September 25th, 1974, Dr. Jobe performed the very first ulnar collateral ligament reconstruction. He first removed a tendon from the wrist of Tommy John’s non-pitching arm, then drilled 4-holes in the bones of the injured elbow, and laced the tendon through the holes in place of the torn ligament.
Return to Play For 14 More Years
After a second procedure to reroute his damaged ulnar nerve, John’s arm was in a cast until January of 1975. When it was removed, he began rehabilitation in earnest. By June, feeling had returned to John’s injured fingers, and by September, he was healthy enough to pitch in an off-season instructional game in Arizona.
On April 16th of 1976, John made his first post-surgery pitch in a major league game against the Braves. In June, he pitched his first complete game since the surgery against the Expos, earning the Dodgers a 6-3 victory.
For Dr. Jobe watching from the stands, those early games had him on the edge of his seat. He wondered, “Is that gonna hold?”
It held, allowing John to pitch the winning game of the 1977 National League Championship Series, and continue performing for 14 more years as a pitcher in the Major Leagues, recording more wins after surgery than prior to in his career.
While the results of Tommy John’s surgery were clearly positive, Dr. Jobe waited two years before performing his 2nd UCL reconstruction on then Padres pitcher Brent Strom, with the help of his partner Dr. Robert Kerlan. Strom’s surgery was successful as well.
From Innovative Procedure to the Standard of Card
While the results of Tommy John’s surgery were clearly positive, Dr. Jobe waited two years before performing his 2nd UCL reconstruction on then Padres pitcher Brent Strom, with the help of his partner Dr. Robert Kerlan. Strom’s surgery was successful as well as he continued to pitch at the minor league level until he retired from play in 1981.
In 1986, Dr. Jobe and two of his colleagues had collected enough data to publish their results in the Journal of Bone and Joint Surgery.
Dr. Frank Jobe (left) with Dr. Lewis Yocum (Right)
Kerlan-Jobe Surgeons Become the Tommy John experts
By 2003, Dr. Jobe had performed the procedure he invented on dozens of Major and Minor league players. Including Tom Candiotti, who had a 16-year career in the majors after the surgery, and Colby Lewis and Joakim Soria who both had 14-year post surgical careers, Todd Worrell, Norm Charlston and John Franco among others.
Dr. Jobe mentored Fellow Kerlan-Jobe physician Dr. Lewis Yocum, team physician to the Los Angeles Angels. Dr. Yocum performed his first Tommy John surgery on an MLB pitcher in 1982. Don Aase, the Los Angeles Angels pitcher who was the beneficiary of that procedure, would go on to play 7-more years in the majors and held a host of renowned players to his patient list including Stephen Strasburg and Jordan Zimmerman.
Dr. Neal ElAttrache began learning how to perform the surgery as a Kerlan-Jobe fellow in 1990, operating with Dr. Jobe twice a week throughout the 1990s. Dr. ElAttrache performed one his earliest Tommy John surgeries on an MLB player in 2013 with Dodgers’ pitcher Chad Billingsley, and continuing throughout the present day, with Tommy John patients who have included players like the late Jose Fernandez and Shohei Ohtani.
All of Kerlan-Jobe’s surgical specialists bear the legacy of Dr. Jobe’s pioneering efforts, and continue as recognized experts in the procedure. To date, our physicians have performed Tommy John surgery on hundreds of active MLB players, and hundreds of other athletes in baseball and other throwing disciplines with UCL injuries.
The Tommy John Explosion
While Tommy John surgery was invented at the Kerlan-Jobe Orthopaedic Clinic (known today as the Cedars Sinai Kerlan-Jobe Institute), it’s been adopted by surgeons and sports medicine specialists around the world.
Throughout the early 90s, the surgery remained relatively rare, with less than 10 MLB pitchers having Tommy John surgery every year. In 1996, the count had nearly doubled. By 2012, a record 69 MLB pitchers had Tommy John surgery in a single year.
Today, MLB players numbering in the hundreds have undergone Tommy John surgery, and it’s estimated that more than 2,200+ surgeries have been performed across all levels of baseball, including high school, college and the minors.
Tommy John (Left) and Dr. Jobe (Right) at the National Baseball Hall of Fame
While the surgery Dr. Jobe invented in 1974 has been a tremendous success, the orthopedic community has continued to look for ways to improve the surgery, reduce recovery times and educate on preventing the injury.
Continued Research & Improvement
As a 2020 medical journal article stated, “Although return to play rates are generally quite high (80–95%), the mean time to return to play (typically 12–18 months for pitchers) is longer than desired.”
As evidence of this quest for improvement, nearly 400 journal articles have been published on Ulnar Collateral Ligament Reconstruction in the past 5 years, with dozens listing Kerlan-Jobe surgeons as contributing authors.
For example, in 2022, four Cedars Sinai Kerlan-Jobe Institute physicians authored the first paper evaluating the rates of return to play for processional baseball players who had experienced a 2nd UCL rupture and repair after having their initial Tommy John surgery.
Unmatched Experience & Professional Levels of Care
No-one has been doing Tommy John surgery longer than the group that invented the procedure, and no-one has more experience treating the injuries of athletes at the highest levels of sport.
If you’d like to access our unmatched level of expertise, and the same level of orthopedic care that professional athletes experience, schedule an appointment today.
