KANSAS CITY – A surgeon in Kansas City reports he has performed the world’s first in-utero Tommy John surgery. A hospital spokesperson states that the elbow and the mother are doing well.
“A majority of ulnar collateral ligament reconstruction surgery is already being done on high school pitchers,” says the surgeon, Dr. F. Lata. “Parents have been pressuring us for years to give their golden-armed children the extra competitive advantage that they deserve.” The extended recovery time after surgery in a young athlete typically interferes with year-round training and pitching as well as with visits to the orthodontist. It also puts the multiple club teams for which the athlete competes at a considerable disadvantage.
In American professional baseball, the prevalence of having operative repair of a UCL injury is 25% in major league pitchers and 15% in minor league pitchers. Strikingly, 26% of collegiate athletes, 30% percent of coaches, 37% of parents, and 51% of high school athletes believed UCL reconstruction should be performed as a prophylactic procedure to enhance performance in an uninjured athlete.
Minimally-invasive fetal surgery is commonplace for problems such as congenital urinary tract obstruction and serious cardiac conditions. Fetal tissues exhibit unique healing properties, especially the ability to regenerate injured tissue rather than healing by scar formation. “Unfortunately the kid won’t be able to impress the girls with his huge scar”, said Dr. Lata.
Limitations to this early surgical approach include the difficulty of assigning hand dominance before the age of 3 years, much less before birth. Advances in genomics may allow the early prediction of handedness based on parental or fetal cell analysis. For children with less well-defined potential, the procedure should be performed prior to the age of 5 years. This will avoid interference with the peak years of training and development.
In-utero reconstruction may avoid loss of playing time in high school or college and avoid set-backs in progression through the minor leagues. Starting pitchers at the Major League level can lose up to eighteen months playing time after Tommy John surgery, a devastating loss for a competitive team. Additionally, this lack of ability to play may influence contract negotiations and impact the player’s total earnings. Teams look favorably on prospects that have already had the procedure.
“The sooner you get this done, the quicker you’ll reach the Big Show,” says Lata.