MLB: New Alternative to Tommy John Surgery Could Be on Horizon

A new procedure could cut the recovery time of Tommy John surgery nearly in half. Relief pitcher Seth Maness is the first major test case in MLB.

Tommy John surgery is a fact of life for many MLB pitchers. A ligament tear in the elbow of a throwing arm is often followed up by the procedure that has become as commonplace as any treatment in baseball. Pitchers who undergo the reconstructive surgery are typically put out of commission for about a year – no short while in the world of Major League Baseball.

A 2013 survey estimated that 25 percent of MLB hurlers had experienced TJS at least once in their careers. That figure has likely only grown since then. The possibility is ever at the back of teams’ minds, especially where young pitchers who throw a lot of innings are concerned. But what if pitchers and their clubs didn’t have to worry quite as much about TJS and all its associated delays? A new alternative procedure with a significantly shorter recovery time could change the landscape of pitchers’ health.

Derrick Goold of the St. Louis Post-Dispatch published an article detailing a new procedure undergone by former Cardinals reliever Seth Maness. The right-hander had surgery in August to take care of the ulnar collateral ligament (UCL) in his right elbow. He initially expected to be having Tommy John surgery. But upon seeing the inside of Maness’ elbow, his doctor identified him as a candidate for a new kind of procedure. One that essentially serves the same function as TJS, but allows a pitcher to return to the mound much sooner.

According to his surgeon, Dr. George Paletta, Maness is the first established MLB hurler to undergo what is being referred to as the “primary repair” procedure. It’s so new that the league has not yet assigned it its own medical code apart from the one already belonging to TJS. While receiving that surgery would have probably wiped out all of Maness’ 2017 season, he’s currently preparing to be ready for Opening Day, just seven and a half months after going under the knife.

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The Cardinals chose not to tender the 28-year-old Maness a contract earlier in the offseason, making him a free agent. He has been throwing recently and plans to get back on a mound for the first time since August sometime next week. Under normal circumstances, Maness might not be the most popular guy on the market, but it’s a safe bet that teams will be watching him closely this spring and into the regular season. Whether they are interested in actually signing him or not, clubs will want to see how he responds to the surgery in case it becomes an option for their own pitchers in the future.

Maness was unremarkable over the last two campaigns, posting a 3.98 ERA and 1.39 WHIP in 95 innings since the start of 2015. However, in 2013 and 2014 he managed a 2.66 ERA and 1.17 WHIP over 142.1 frames. He’s never been much of a strikeout artist (career 5.8 K/9; only 4.5 K/9 last year), but Maness routinely keeps the ball on the ground with a lifetime 58.9 percent ground ball rate. Someone will take a flyer on him and hope he recaptures the form of his earlier career.

If Maness can prove his physical health as well, it could represent the start of a major advancement in the way elbow ligament injuries in pitchers are treated. Tommy John first underwent the procedure that now bears his name in 1974. Though the surgery has given countless hurlers a new lease on life, it still comes with its share of variables and uncertainties. With TJS cases exploding in the last few years into what some have called an “epidemic,” a more efficient surgical alternative would be a welcome development in the eyes of players and teams.

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Goold points out that for now the procedure is an option for “select big-league pitchers.” The specific location of the UCL tear plays a key role in determining whether a player can have the surgery. Tears near either end of the ligament make the primary repair procedure a possibility.

There’s no telling if it will grow as ubiquitous as Tommy John, or even replace it entirely. But the road to finding out begins now with Seth Maness. Perhaps one day baseball will exist in a space-age future where injuries are treated instantaneously and DL trips are about as unheard of as the concept of the pitcher batting. (Just kidding – or am I?)