Partial UCL Tear, PRP or Surgery?

My son underwent  TJ repair the beginning of July.  Started throwing program in September and was fully released to play in early January.  He is only catching and not pitching, but so far no issues with unleashing it when he has to and he says no pain at all.

One thing that I would be aware of...our doctor said that there is no way to 100% know whether it will be repair or full-blown TJ until they get in their and look at it with their own eyes.  You have to be prepared that when you have the surgery, it may be full blown TJ and a year + of rehab.  First thing my son did in recovery was check his wrist that had been prepped as the donor ligament....and got excited when there was no bandages there meaning that the repair had been performed.  

So very sorry to hear this. I know how long and hard your son has worked. 

I have no answers but I do have a question. I was listening to the D3 podcast yesterday and the host who is a former pitcher mentioned that he has a torn UCL from his own D3 playing days. Am I mistaken in thinking that if you’re not an overhead thrower, you can go through  life with a torn UCL without pain or loss of normal motion? If that’s true it seems to me that the calculations relating to these options may be a little different for your son compared to a younger player. 

My son who is quite a bit younger (2022) ,had TJ surgery last April. We opted for the PRP treatment before surgery. He actually had more pain in his elbow after the PRP treatment than before. A follow up MRI actually shown that the PRP did promote healing of his partial tear but with the pain worst the Dr. recommended surgery. After the surgery the Dr. said he was glad we went with that option because the actual damage was worst than the MRI revealed. 10 months post surgery he has had 0 pain and said his arm feels better than it has in a couple years so all in all a good option for him. One thing I truly believe is the DR. never knows the true extent of the damage until your arm is open... If you opt for surgery I wouldn't wait much longer to do so. After 10.5 mos we are taking it slow but my son is throwing at 80-90% effort. Hopefully the repair is a option for your son, we thought about it but with mine being so young we went for the whole deal.

My son who was a position player had a partial tear while in college.  We met with 3 different orthopedic specialists, not looking for the diagnosis that we/son wanted but someone who made the most sense.  We ended up choosing the specialist who is affiliated with MLB & NFL teams.  Son went PRP route, procedure was painful but tolerable, and instructed not to pick up a ball for a month.  Then another 6-8 weeks of rehab and was given the green light.  For him hopefully it worked (or at least bought him time).  Looking back it appears the correct choice was made since sitting out a year would have most likely changed his future.  Check with your insurance since back then it wasn't covered, considered "experimental".  Cost wasn't too high, maybe 2-3 out of town showcases costs.  Good luck in either direction you choose.   

Twoboys posted:

Dear all

Long story, but our LHP who had been throwing great when P and C had to report back to college in January, including a new personal best high velocity number, felt a jerk in his elbow 2 weeks ago.  He bent over in pain and could not finish his bullpen.  Trainer thought it was just a strain as he did not have any numbness or tingling which is often a symptom of a tear.  Short version of the story, the pain continued, next steps were orthopedist visit and then MRI arthogram, which showed a partial tear.  First Dr recommended 2nd Doctor.  

Second orthopedist (who knows throwing injuries) recommends either PRP or repair surgery, not full blown Tommy John because of where the tear is, size of tear etc.  Success rate for PRP is about 70% or so but no guarantees and it takes about 5 or so weeks to know if it works.  Repair surgery takes 6-9 months to be throwing full effort again.  

Coach already decided he is a medical red shirt this year (at a HA very competitive D3) so it is not about this year, but being ready to contribute next year, his senior year.  Clearly he also maintains a year of eligibility too, we know that, if he wants it.  Given where his velo was before the injury, there would likely be many, many possibilities if he were healthy and back to where it was just a few weeks ago.  

Any HSBW wisdom or knowledge or advice as he has to decide asap which way to go?  He is leaning towards the surgery as it seems the risk the PRP won't work and he will need the surgery anyway is pushing him in that direction.  I tend to agree.  

**Just saw the HS 2021 who was asking about TJ surgery.  I am not asking for medical advice just any experiences with PRP or the partial repair surgery.  

 

 

 

From a Dad of a kid who had both PRP and UCL primary repair with internal brace done by Jeff Dugas at Andrews Sports Medicine. PRP didn't work for him, and is hit or miss from what I've heard from doctors. My son had the surgery Fall of his Junior year and pitched and played the following Spring/Summer. If it's a partial tear there's a decent chance he's a candidate for the repair, but as others have said the Dr won't know for sure until he opens it up. So you do have to be prepared for the possibility that it could be full TJ. But a doctor experienced with the surgery (and I would get the most experienced possible) should be able to give you a decent degree of confidence beforehand. Son is now playing as a freshman in college. Good luck.

Thanks to everyone for the thoughts...yes my understanding is that the UCL is only needed for overhead throwing.  Son is not feeling any pain just walking around, or even swinging a bat.  

We are going ahead with the surgery option, just waiting for it to be scheduled.  He wants to ensure he has the best chance to pitch next fall/spring.  

Regarding PRP it should be noted that there is little evidence for efficacy of PRP. This means PRP might not be much better than placebo and rest. Now some suggest suggest it could have some positive effect but the data are not really strong.

So the big question is whether if the injury is something that could resolve itself with rest. Only a doctor can answer that. It feels that most guys in mlb who are treated conservatively will need TJ anyway but there are cases like tanaka who  can avoid it for quite some time.