An MLB pitcher is able to get Tommy John surgery in Florida during COVID-19 outbreak. Why?
New York Mets pitcher Noah Syndergaard is scheduled to undergo Tommy John surgery in South Florida on Thursday after tearing the UCL in his right elbow during spring training.
Dr. David Altchek, the Mets’ medical director, will perform the surgery at the Hospital for Special Surgery’s West Palm Beach location.
Under normal circumstances, clearance for this type of surgery wouldn’t be an issue. The biggest concern would be Syndergaard’s recovery time. It typically takes a pitcher a minimum of 12 to 15 months to recover from the surgery if there are no setbacks.
But in the age of the coronavirus pandemic, there was another hurdle to go through before the surgery could take place.
Florida Gov. Ron DeSantis on Friday, due to the COVID-19 outbreak, issued an executive order in the state prohibiting elective surgeries or procedures that do not “place a patient’s immediate health, safety, or well-being at risk, or will, if delayed, not contribute to the worsening of a serious or life-threatening medical condition.” The reasoning for this is to lessen the strain on hospitals in the state as more cases of COVID-19 are confirmed and more hospitalizations from the disease become inevitable.
So how is Syndergaard able to have his surgery?
Mets general manager Brodie Van Wagenen said in a statement released by the team Tuesday that Syndergaard experienced “discomfort” in his elbow before spring training was suspended because of the coronavirus pandemic. An MRI revealed a UCL tear. A second opinion confirmed surgery was Syndergaard’s best option.
Newsday also reported Tuesday night that in addition to the UCL tear, Syndergaard is also dealing with “acute compression of his ulnar nerve,” which can cause long-term damage if left untreated.
The Hospital for Special Surgery’s website lists “ligament tears in which timely treatment is necessary” and “significant nerve injury or problem” among surgeries deemed essential.
“Noah is an incredibly hard worker and a tremendous talent,” Van Wagenen said in the statement. “While this is unfortunate, we have no doubt that Noah will be able to return to full strength and continue to be an integral part of our championship pursuits in the future.”
Syndergaard will be at least the fifth MLB pitcher since spring training started in mid-February to either undergo or be recommended to undergo Tommy John surgery. The others: the San Francisco Giants’ Tyler Beede, the San Diego Padres’ Andres Munoz, the New York Yankees’ Luis Severino and the Boston Red Sox’s Chris Sale.
The surgery at the very least sidelines Syndergaard — and whoever else has the surgery — for the 2020 season (whenever it starts) and most likely for the start of 2021 as well even if everything with the surgery and rehab goes according to plan.
“I know that I’m going to get criticized for taking care of these kinds of guys, but it’s essential to their livelihoods,” Dr. Neal ElAttrache, a team physician for the Los Angeles Dodgers who provided the second opinions for both Beede and Syndergaard, told the San Francisco Chronicle. “If you have somebody’s career at stake and they lose two seasons instead of one, I would say that is not a non-essential or unimportant elective procedure.”
The surgery, colloquially named after former MLB pitcher Tommy John who first received the operation in 1974, is a relatively quick operation, taking usually between 60 and 90 minutes to complete, according to Johns Hopkins Medicine.
“UCL reconstruction is a surgery commonly used to repair a torn ulnar collateral ligament inside the elbow by replacing it with a tendon from elsewhere in the body,” according to Johns Hopkins. “The goal of the surgery is to stabilize the elbow, reduce or eliminate pain and restore stability and range of motion.”
The elbow is put in a brace between a 60- and 90-degree angle after surgery “to protect the healing tissue and reduce inflammation.” Physical therapy can begin at this point on the wrist, fingers, shoulder and biceps.
About two weeks after surgery, the elbow joint can start being moved. The elbow will be able to fully extend about a month after the surgery and normal range of motion usually returns about two to four months after the operation.
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