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John Surgery Has Been a Cut Above the Rest

Orthopedist Frank Jobe's revolutionary surgery, performed first in 1974, has saved the careers of several baseball players.

September 28, 2003|From Associated Press

The bullpen door swings open at Dodger Stadium and out runs the most dominant closer in baseball.

Bushy hair flowing from beneath a dirty blue hat. Angry eyes peering through big prescription goggles.

And one other thing about Eric Gagne, far less noticeable: A six-inch scar on his right forearm, a reminder of the Tommy John surgery that saved his career, along with nearly 100 others.

Of course, Dodger team orthopedist Dr. Frank Jobe wasn't thinking about making such a major impact on the sport when he first performed the operation in 1974. He was focused on giving John another opportunity to pitch after the Los Angeles lefty shredded his elbow ligament in the third inning against Montreal.

"I told Tommy the chances were less than 1-in-100," Jobe recalled. "We did it and it worked. It was kind of lucky it did."

Said John: "I am sure there were a lot of players that thought I was crazy. I wanted to play ball."

The procedure, innovative at the time, now has a 93 percent success rate, according to Jobe.

It has rescued right-handed starters (Matt Morris, Kerry Wood) and left-handed starters (David Wells), closers (Mariano Rivera, John Smoltz, Rod Beck, Tom Gordon, Matt Mantei) and closers-turned-middle relievers (Scott Williamson, Billy Koch).

Infielders (Paul Molitor) and outfielders (Jose Canseco, Jay Buhner, Jay Payton, Xavier Nady) have benefited. So have future prospects (Dewon Brazelton at age 15) and an older generation of players (John Franco at age 41).

"I'm just so fortunate that surgery even existed," Gagne said recently. "[Tommy John] and Dr. Jobe are the reasons why I have a career, and now I can just enjoy it and play baseball every day."

The surgery replaces the stabilizing ligament in the elbow with another tendon from a wrist, back of an ankle or a hamstring.

Jobe based the procedure on successes with polio patients who had muscle damage in their ankles, and with patients who had cut tendons in their hands.

The fact that it worked with Tommy John turned out to be a bonus to Jobe. From then on, he knew what to call the operation.

"It is two first names. It rolls off your tongue nicely," Jobe said. "When you say it, everyone knows what it means. Reconstruction of the ulnar collateral ligament with the palmaris longus tendon is a mouthful."

Sandy Koufax, the Dodgers' Hall of Fame left-hander, retired at age 30 in 1966 with an arthritic elbow. A decade later, and maybe Jobe could've made a difference.

"I think Sandy would have benefited from Tommy John surgery. Sandy thinks the surgery would have helped, in retrospect. I wasn't smart enough to diagnose it then," Jobe said.

The post-surgery rehabilitation process usually takes 12 to 18 months, a model based on John's comeback. A player can start sponge squeezing immediately, lifting light weights in six weeks, followed by tossing a baseball in four months.

At seven months, a pitcher throws at half-speed from the mound. If pain free, there are no restrictions in 12 months, enough time for the body to accept the new graft and make it part of the elbow.

There are pitchers who return with a livelier fastball because of better mechanics, a stronger body from rehabilitation and an elbow without a fraying or stretched ligament.

"Tommy John surgery doesn't give them superhuman powers," Jobe said. "We don't want them to think we have some mystical powers that make them better."

Smoltz, one of only four players to speak with John before or after having the procedure, flirted with returning in 2000, less than six months after surgery. He had two setbacks in 2001 as a starter.

"You'll get fooled. You'll get fooled," John said. "You can't rush it. They make a mistake coming back too fast. They'll get burnt by it."

Payton had the surgery two times.

"I didn't have a choice for the second one," the Colorado outfielder said. "It was either have it again or quit playing baseball, basically, because the first one didn't take and it just didn't heal up."

Gagne was lucky his elbow recovered. Long before he began setting saves records this season, his career was in jeopardy.

Gagne threw a fastball one day at Class A Savannah in 1996 and pitched the next seven months with arm stiffness and pain, a fact Jobe didn't even know.

Even after an MRI exam at spring training in 1997 revealed a torn ligament, Gagne balked at having surgery.

So, what would the Canadian-born All-Star done if Tommy John surgery never existed?

"I thought about going back to play hockey," Gagne said. "I thought about going back to school for a psychology degree at McGill University in Montreal."

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