Roegele: Tommy John surgery success rates in the majors

From SABR member Jon Roegele at The Hardball Times on March 23, 2015:

There has been a growing public perception that with today’s skilled surgeons and rehabilitation experts, undergoing Tommy John surgery is more of a one-year layoff in a major league pitcher’s career than a procedure that puts his career in jeopardy. A corollary of this belief is that trying the rest-and-rehab route on a partially damaged ulnar collateral ligament is not worth the effort, as it ends up only delaying the inevitable Tommy John surgery, which while costly is a nearly automatic method of restoring a pitcher’s health so he can pitch at the major league level again.

A number of studies both in the academic arena and the public research space have arrived at similar success rates for Tommy John surgeries. The American Journal of Sports Medicine has published a number of such studies. One reported a return to major league baseball rate of 83 percent, one reported a return rate of 80 percent, and a third reported a return rate of 79 percent. My own Tommy John surgery database calculates a running total of return rates to MLB, for which the current rate for all surgeries performed before the end of 2013 is 78 percent. So right away we can see that full recovery from the surgery is not so automatic, that only four of five pitchers who undergo the surgery after making the majors return to pitch there again.

The definition of “success” in each of those four studies is a return to pitch in a single major league game. This is certainly an understandable and worthwhile metric to measure. It implies that a number of rehabilitation milestones were reached and that his organization feels the pitcher is ready for big league action.

I would submit that a more relevant question would be how often pitchers return and contribute in a meaningful way. After all, a pitcher returning to make an appearance or two over a mere handful of innings, then falling out of the major league level for whatever reason, can hardly be considered a successful outcome for the player or his organization.

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Originally published: March 23, 2015. Last Updated: March 23, 2015.