Experience with RPP vs. internal brace for proximal UCL tear?

Sorry to hear it and wishing you the best.

@Francis7 posted:

Sorry to hear it and wishing you the best.

Thanks. All things considered could be a lot worse. After his first visit, and before the MRI he was frustrated not knowing what was going on. It's pretty black and white now.

This morning we called and scheduled his surgery.

Son had proximal tear and had the internal brace at the end of April. So far so good as far as PT and training are going. Surgeon felt he should be able to pitch in the spring. Good luck to your son.

@baseball mom2020 posted:

Son had proximal tear and had the internal brace at the end of April. So far so good as far as PT and training are going. Surgeon felt he should be able to pitch in the spring. Good luck to your son.

Thank you. I realize every case is different. Is your son throwing now?

Started throwing 3 months after surgery. Just tossing plyos. Not allowed to pitch off mound until end of December

My son had an internal brace. I know 2 kids who chose prp, not sure how common it is but both had TJ the next year.

I will also recommend moving the ulnar nerve at the same time.

@baseballhs posted:

I will also recommend moving the ulnar nerve at the same time.

Funny you mention this. My son has surgery scheduled for this Thursday, and it was a bit difficult to get scheduled because it's going to require two surgeons. One is there to just move the ulnar nerve apparently.

If you're kids were driving when they had this surgery, how long until they were able to drive agin? Looks like my son will have a followup with ahis doctor 7 days after his surgery where they will remove the cast and put him in a brace.

Mine drove as soon as he was off meds. Who is doing your surgery? That said, we didn’t have a cast, just the metal brace, and he did PT the very next morning.

@baseballhs posted:

Mine drove as soon as he was off meds. Who is doing your surgery? That said, we didn’t have a cast, just the metal brace, and he did PT the very next morning.

Thanks.  An ortho surgeon by me that's AMSI affiliated. When my kids were younger and had various aches and pains he was referred to me by Dr. Flesig. I'm assuming he'll have a cast, we'll see.

@nycdad posted:

Thanks.  An ortho surgeon by me that's AMSI affiliated. When my kids were younger and had various aches and pains he was referred to me by Dr. Flesig. I'm assuming he'll have a cast, we'll see.

Our surgeon has a room next to surgery where you actually watch the surgery on a screen and through the window.  I've sadly seen two in the last year but it is crazy what they are able to do.

The kids' team orthopedic surgeon did the PRP thing. $600 not covered by insurance. Also did MRI without using dye. Went to a Dr. Timothy Kremchek. Explained to him the kid was at the end of his college career and could not afford a misdiagnosis. He went in and did the full TJ. Stated sometimes you can't tell until you get in there. He also took a ligament out of the kid's wrist. Stated it's a useless ligament and not everyone has it.

@baseballhs posted:

Our surgeon has a room next to surgery where you actually watch the surgery on a screen and through the window.  I've sadly seen two in the last year but it is crazy what they are able to do.

The kid's was video recorded and given to him.

Yes we got both of ours on a drive.

@SomeBaseballDad posted:

The kids' team orthopedic surgeon did the PRP thing. $600 not covered by insurance. Also did MRI without using dye. Went to a Dr. Timothy Kremchek. Explained to him the kid was at the end of his college career and could not afford a misdiagnosis. He went in and did the full TJ. Stated sometimes you can't tell until you get in there. He also took a ligament out of the kid's wrist. Stated it's a useless ligament and not everyone has it.

Didn’t see this one. We went to Kremchek too.

Son had surgery last Thursday. Went well according to the surgeon. Took one of the prescribed pain killers the first evening, but hasn't needed anything since.

Gets cast removed this Weds at his first follow up, and will head straight to hi PT after.

So figure I'd just add to this thread....

Kid #2 (soph RHP) Is having TJ surgery next week (if they can schedule it). Had forearm pain in the fall. Took him to the ortho he's been to for years and where his older brother had TJ (internal brace) back when I started this in August. At that time, based on two MRIs (regular and contrast based) they said it was a sprain. Of course all sprains are tears, but surgery wasn't recommended.

He rehabbed over the fall and was having a good season. Went from first out of the pen to Friday starter. Coaches were responsible with pitch counts and he was having success.

After his start two weeks ago which was his worst outing (velo didn't drop though) he had pain after a few days when he normally only has soreness for a day a two.

After working with the trainer and skipping a start it wasn't getting better. We made an appointment to see Dr. Ahmad. Ahmad wasn't around for about a week, so we had the school get him an X-Ray and then get him an MRI.

Side note....If you have good insurance try to do all this yourself, You'll get things done faster and most schools are  listed as secondary insurance anyway.

He saw Ahmad today. Ahmad saw a small tear and his UCL is "spongy" meaning there are likely smaller tears. Based on the imaging and the tests Ahmad did, the plan is for TJ surgery with an internal brace. I was confused by this because I thought it was one or the other. Apparently Ahmad is the only one doing this now. They take the tendon from his wrist, and wrap it in the collagen they use for the internal brace. He's estimating 8-10 month before return to play. So hoping by conference play next season and my son went back to school and started inquiring with the athletic department about a waiver for this season so it counts as a red shirt year.

Can't really think of one thing this year that caused this. According to Synergy his average velo is up ~4mph this season, but he's not upper 90s. Seems like this has been brewing for a while.

I guess so much for a "heir and a spare" ;-)

So sorry to hear that they are both down.

@nycdad posted:

He saw Ahmad today. Ahmad saw a small tear and his USCL is "spongy" meaning there are likely smaller tears. Based on the imaging and the tests Ahmad did, the plan is for TJ surgery with an internal brace. I was confused by this because I thought it was one or the other. Apparently Ahmad is the only one doing this now. They take the tendon from his wrist, and wrap it in the collagen they use for the internal brace. He's estimating 8-10 month before return to play. So hoping by conference play next season and my son went back to school and started inquiring with the athletic department about a waiver for this season so it counts as a red shirt year.

I am pretty sure Meister was the first to do TJ + brace, about 2-1/2 years ago. They graft the vestigal palmaris tendon onto the ulna and humerus, and then use a collagen-soaked wrap to repair the original UCL. After recovery, the patient essentially has two UCLs instead of one.

TJ+brace is slowly becoming more common but it's new enough that it’s mostly being done only at the large academic health centers. Peer-reviewed documentation about recovery time and outcomes is still thin.

Ahmad probably meant he's the only orthopedist at Columbia doing the procedure. I know there's a couple docs at NYU who've had successful outcomes.

Feel free to send a DM if you'd like more info.

Conway does it too. We have a freshman who had it done last year. Just hit 100mph last weekend. (Results vary He is also 6’7 and 220).

@baseballhs posted:

Conway does it too. We have a freshman who had it done last year. Just hit 100mph last weekend. (Results vary He is also 6’7 and 220).

Bixby is a beast! My son is friends with him. He was at the event with him when he originally got hurt. Good to see how well he bounced back after the surgery. We watched him on tv a couple of weekends ago against Cincinnati when the announcers starts calling him Cheese Whiz.

Yes, nice family. He is a huge kid.

Son had brace with Ahmad last April. He has been pitching but his Velo is way down from prior to tear. 2 others on the team had the same surgery. Looks like a third might be headed that way too. The first ones velo never came back and he is out. Not sure what I think about all of this other than hopeful that my kid will at least be able to play golf in the future with his friends lol.

@baseball mom2020 posted:

Son had brace with Ahmad last April. He has been pitching but his Velo is way down from prior to tear. 2 others on the team had the same surgery. Looks like a third might be headed that way too. The first ones velo never came back and he is out. Not sure what I think about all of this other than hopeful that my kid will at least be able to play golf in the future with his friends lol.

I’m sorry. Wishing you and your son the best.

@baseball mom2020 posted:

Son had brace with Ahmad last April. He has been pitching but his Velo is way down from prior to tear. 2 others on the team had the same surgery. Looks like a third might be headed that way too. The first ones velo never came back and he is out. Not sure what I think about all of this other than hopeful that my kid will at least be able to play golf in the future with his friends lol.

Sorry your son's velo hasn't come back. Are all the players you mention going to the same doc, PT, and getting their RTT from the same people? Hard to tell what's going on with so many variables.

My son (who I originally started this thread about) is doing well, Velo back to where it was. It has taken him longer to return than what was originally told. But I think that may be the case with just the internal brace.