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Savior of pitchers' elbows

March 07, 2014|Valerie J. Nelson

In the summer of 1974, Dodger pitcher Tommy John heard his arm snap like a guitar string after delivering a pitch. The torn ligament was the type of injury that commonly ended athletic careers, but John, then a 31-year-old star, pushed team doctors "to figure it out."

Orthopedic surgeon Dr. Frank Jobe made what many consider the most extraordinary medical advance in baseball history that September when he invented a transplant procedure that resurrected the pitcher's arm.

Jobe borrowed the idea of transferring a tendon from one body part to another, which had been used in hand surgery and to reinforce the joints of polio patients but never to repair a joint that endures so much stress -- the elbow of a major league pitcher.

He snipped a 6-inch tendon from the pitcher's good arm and wove it like a figure eight through holes drilled in the elbow of the injured left arm to replace the ligament destroyed by overuse. It worked so well that Pete Rose, then a player with the Cincinnati Reds, quipped: "I know they had to give Tommy John a new arm. But did they have to give him [Sandy] Koufax's?"

Jobe, 88, died Thursday in Santa Monica, the Dodgers announced. No cause was given.

"Many of us go into medicine thinking we are going to change the world, and it just doesn't happen, certainly not to this magnitude," Dr. Timothy Kremchek, the Cincinnati Reds' medical director and one of the few doctors who perform the Tommy John procedure on major league pitchers, said in a 2005 interview with The Times.

Over the next 30 years, Jobe saved hundreds of pitching careers by performing the surgery. He attributed its popularity in part to the increase in million-dollar salaries, which put pressure on team doctors to consider near-bionic solutions to keep such players in the game.

Dr. James Andrews, a Jobe protege widely credited with perfecting the Tommy John surgery, has repeatedly called Jobe a founding father of sports medicine who brought treatment for baseball players out of the Dark Ages.

"Jobe initiated all of the things that have made elbow injuries both commonly recognized and treatable," Andrews, an orthopedic surgeon in Birmingham, Ala., told Investor's Business Daily in 2002.

As of 2013, more than 1,000 Major League Baseball players -- most of them pitchers -- had undergone the Tommy John procedure, the popular term for ulnar collateral ligament reconstruction.

"The impact he's had on the game can't be measured," Lewis Yocum, the longtime team physician for the Los Angeles Angels and Jobe's colleague, said in 1999. Yocum died in 2013.

The Baseball Hall of Fame honored Jobe last summer for developing the "historic elbow procedure" that has helped extend so many major league careers.

"Baseball lost a great man and Tommy John lost a great friend," John said in a statement Thursday night. "There are a lot of pitchers in baseball who should celebrate his life and what he did for the game of baseball."

If the Tommy John procedure remains the Mona Lisa of sports surgeries, as Times sportswriter Chris Dufresne once declared, then Jobe's landmark 1990 operation to rebuild the right shoulder of then-Dodger Orel Hershiser could be enshrined down the hall in the Louvre.

When Hershiser, a Cy Young Award winner who led the team to the World Series in 1988, needed surgery to repair cartilage damage and tighten the ligaments in his shoulder, Jobe proposed a revolutionary procedure that had been done on only about 30 people. None were major-league pitchers trying to throw 90 mph fastballs.

Until then, such an operation meant disturbing and damaging muscles, which made it almost impossible for a pitcher to come back. Jobe designed a less-invasive approach -- instead of detaching the muscle to repair the joint, he split the muscle and made the repair. He used microscopic tools and newly invented anchors that secured the ligament to the bone, minimizing trauma.

Hershiser recuperated from the 45-minute operation in secrecy and allowed no photographs of his 13-month rehabilitation. After winning his first game post-surgery in 1991, he threw a party in honor of Jobe and gave him a trophy.

"He gave me back the thing I love," said Hershiser, who went on to pitch 10 more seasons and in two more World Series with the Cleveland Indians.

The two medical breakthroughs "revolutionized baseball because they have kept players on the field," Kremchek said.

Jobe, whose elegant hand strokes in the operating room have been compared to those of a symphony conductor, repeatedly said he would rather be remembered for the strides he made that kept athletes off the operating table.

In 1979, he established a biomechanics laboratory at Centinela Hospital Medical Center in Inglewood and pioneered motion analysis on the act of throwing. Rotator cuffs, a series of muscles that control overhead shoulder motion that can be abused by pitching, were the subject of the first study.

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