Triple Tommy John (TJ3) Explained
Understanding the differences between TJ3 and traditional Tommy John Surgery
Introducing the revolutionary TJ3 procedure, also known as The Triple Tommy John, a groundbreaking advancement in Tommy John surgery. TJ3 represents a new era in UCL reconstruction, offering baseball players at all levels faster, smoother recoveries with fewer setbacks and extended career longevity. This innovative approach aims to increase success rates and accelerate rehabilitation, meeting the heightened demands of today’s amateur and professional baseball players.
TJ3 — Advancement & Observations
Triple Tommy John is a significant advancement in elbow UCL reconstruction. This innovative technique combines native ligament repair with an internal brace and ligament reconstruction, paired with remarkable bio-engineering technology. TJ3 offers a comprehensive solution for athletes with UCL injuries. The initial results are impressive, with several hundred patients benefiting from this cutting edge procedure. Players also report significantly less soreness throughout their rehab and throwing progressions, contributing to smoother recoveries. Most importantly, many athletes accelerated the recovery timelines to get back to an important season, such as highschool junior year recruitment season, and returned to play sooner than expected. Shaving off rehab time can create incredible opportunities for players at all levels.
Triple Tommy John Explained
Repairing The Native Ligament — The first step in TJ3 is to repair the native ligament. This approach, utilizing strong sutures, aims to encourage natural healing and restore the ligament’s original function. For tears that have limited to no healing capacity, especially those in the distal portion of the ligament (closer to the forearm), a suture anchor is used to directly repair the UCL and enhance the healing process. This technique, using a small anchor that is inserted into the bone, secures the repaired ligament, improving stability and promoting healing. Healing of the native ligament is faster than healing of the reconstructed ligament.
The Internal Brace — A critical innovation is the use of an internal brace, a device that provides extra support and protection for the UCL. This brace is made of strong, bio-compatible material and is secured to both the ulna bone (forearm) and the humerus bone (upper arm) at a specific location known as the medial epicondyle. The internal brace acts as a reinforcement for both the repaired ligament and reconstructed ligament, helping to prevent it from stretching or tearing again.
Ligament Reconstruction — A ligament reconstruction is stronger than the original ligament. This procedure involves using a graft, typically taken from a tendon in the wrist or below the knee, to replace the damaged ligament. Holes are drilled into the bone near the native ligament’s attachment points, and the graft is then woven through these holes, secured in a “docking” fashion. This creates a strong, durable replacement ligament that helps to restore the stability of the elbow joint. While the reconstruction takes lengthy time to heal, the internal brace protects it during the healing process.
When all three of these components are performed together, the result is a more comprehensive and robust reconstruction, TJ3, one that offers greater strength, durability, and the potential for accelerated healing. This approach is designed to maximize the chances of a successful recovery, allowing athletes to return to their sport as quickly and safely as possible.
Understanding the Difference Between TJ3 and Traditional Tommy John Surgery
Traditional Tommy John Surgery involves reconstructing the damaged UCL using a tendon graft, typically sourced from the patient’s wrist or hamstring. While this method has been highly effective for 50 years, recovery can take 12–18 months, and risks of re-injury are still significant, particularly for modern athletes throwing with extreme velocities and spin rates.
TJ3 (Triple Tommy John Surgery) is an advanced procedure that addresses key shortcomings of traditional TJS. It integrates three elements:
1. Native ligament repair for faster healing
2. An internal brace made from bio-engineered materials to provide protection & additional support
3. Ligament reconstruction with a tendon graft, for additional strength
The key difference lies in the added internal brace and ligament repair, which work together to enhance the stability and healing of the UCL. This multi-layered approach not only reduces the time needed to return to play but also offers increased durability, reducing the risk of re-tears. Initial results show faster rehabilitation, tighter flexion during recovery, and fewer cases of post-op soreness, helping players return stronger and sooner.
By combining ligament repair, an internal brace, and reconstruction, TJ3 presents a comprehensive and more resilient solution that caters to the heightened physical demands of today’s athletes. It’s designed not only to heal the UCL but to fortify it against future injuries, allowing players to push their performance without compromising long-term health.
The Internal Brace And Bioengineering Technology
The internal brace, a critical advancement in modern UCL reconstruction,
represents a remarkable blend of bioengineering — combining strength with biocompatibility to provide enhanced support for the repaired ligament. Picture a high-tech rope designed to restore elbow stability, crafted from specialized materials that work together seamlessly. This “tape’ known as Arthrex Collagen Coated Tape, consists of two main components: ultra-high-molecular-weight polyethylene (UHMWPE) fibers and collagen. The UHMWPE fibers are a super-strong plastic, similar to materials used in fishing lines or bulletproof vests, providing the core strength of the tape. This incredible durability is crucial for reinforcing the UCL, allowing it to withstand the immense forces generated during pitching.
However, strength alone is not enough. The tape must also be biocompatible to integrate smoothly with the body’s tissues and promote healing. This is where the collagen coating plays a vital role. Collagen, a natural protein found throughout the body, forms a friendly outer layer that encourages the body’s tissues to heal around the synthetic fibers. The unique combination of the strong UHMWPE fibers and the healing properties of collagen makes Arthrex Collagen Coated Tape ideal for UCL
reconstruction. It offers the structural support necessary to protect the repaired ligament while fostering a healing environment, reducing the risk of complications. This innovative approach exemplifies the ongoing advancements in sports medicine, where cutting-edge science and engineering enhance athletes’ recovery and longevity.
TJ3 Procedure — Full Surgical Video
Warning, graphic surgical scenes (age- restricted content)
