This retrospective epidemiologic study used the PearlDiver private-payer database to characterize who is actually getting Tommy John surgery in the United States. It captures 790 UCLR procedures performed from 2007 to 2011, examining age, sex, geography, and timing trends.
The typical Tommy John patient is not a professional pitcher — it's a 15-19 year-old male with private insurance, and the volume of these procedures in adolescents is growing at nearly 10% per year.
This matters clinically because patient and family counseling needs to address two pervasive misconceptions: that UCLR improves performance (it does not. It restores preoperative function only), and that return to sport is under 9 months (it is generally over 1 year).
The Q2 peak in procedures identifies the off-season to in-season transition as the highest-risk period for UCL injury. Pitch count limits and load management during spring are where prevention resources should be concentrated.
The study is limited to a private-payer database, which likely overrepresents higher-income, competitively active athletes. So these numbers may undercount the true national burden while overrepresenting surgically managed cases. For boards: know that the 15-19 age group carries an incidence of 22 per 100,000, roughly five times the overall rate of 3.96 per 100,000, and that this gap is widening.
This retrospective epidemiologic study used the PearlDiver private-payer database to characterize who is actually getting Tommy John surgery in the United States. It captures 790 UCLR procedures performed from 2007 to 2011, examining age, sex, geography, and timing trends.
The typical Tommy John patient is not a professional pitcher — it's a 15-19 year-old male with private insurance, and the volume of these procedures in adolescents is growing at nearly 10% per year.
This matters clinically because patient and family counseling needs to address two pervasive misconceptions: that UCLR improves performance (it does not. It restores preoperative function only), and that return to sport is under 9 months (it is generally over 1 year).
The Q2 peak in procedures identifies the off-season to in-season transition as the highest-risk period for UCL injury. Pitch count limits and load management during spring are where prevention resources should be concentrated.
The study is limited to a private-payer database, which likely overrepresents higher-income, competitively active athletes. So these numbers may undercount the true national burden while overrepresenting surgically managed cases. For boards: know that the 15-19 age group carries an incidence of 22 per 100,000, roughly five times the overall rate of 3.96 per 100,000, and that this gap is widening.