The Associated Press reports how tommy john surgery has evolved over the past 50 years in an interview with David W. Altchek, MD, co-chief emeritus of the HSS Sports Medicine Institute.

In the 50 years since Dr. Frank Jobe ‘s first Tommy John surgery, the operation has saved careers and earned fortunes.

Dr. Altchek performed Tommy John surgery on Zack Wheeler in 2015, and he returned to the field just two years later. 

Texas Rangers team physician Dr. Keith Meister combined traditional Tommy John ligament replacement with the internal brace promising increased longevity and enhanced strength for pitchers undergoing the surgery, known as a hybrid procedure. 

“His theory is that players are throwing so much harder, with also so much spin, that they are putting so much stress on that ulnar ligament,” Altchek said. “He thinks the failure rate is creeping up — we just haven’t proven it statistically yet — and therefore adding this synthetic strong suture will protect the the reconstruction over time.”

Innovations such as laser therapy and Piezoelectric therapy stimulate tissue healing by promoting the release of nitric acid, which causes blood vessels to widen. Blood flow resistance is another technique.

“It sounds crazy,” Altchek said. “You put a tourniquet on the arm, you blow it up to a certain percentage of the patient’s blood pressure, cutting off part of the blood supply and then you exercise in that range for 10, 15 minutes, and then you let the tourniquet down. ... The local muscles actually release hormones in a fight or fight way and it stimulates healing.”

These innovations reflect a broader shift towards prioritizing better healing and long-term outcomes in sports medicine.

Read the full article at apnews.com.