How Many MLB Players Have Had Tommy John Surgery?

Author:
Kelley Marks
Updated:
Jul 21, 2024

Hong-Chih Kuo, shown here pitching for the Seattle Mariners, has the dubious distinction of undergoing four Tommy John surgeries. Jose Rijo reportedly has had five.
Derral Chen via Wikimedia Commons

Modern sports, particularly baseball, wouldn’t be the same without the advent of Tommy John elbow reconstruction. In the old days, when a baseball player developed what was often called a “dead arm” nothing could be done except tell him it was time to retire.

Hall of Fame left-handed pitcher Sandy Koufax retired at the age of 30 because he reportedly had an arthritic left elbow that hurt almost constantly when he pitched. But some think he really needed Tommy John surgery.

How many more years could Koufax have pitched if he had had the surgery? Another five to ten years? Who’s to say? Too bad Koufax wasn’t born about 10 years later!

Let’s explore Tommy John surgery and see how many Major League Baseball players have had this now commonplace operation.

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What Is Tommy John Surgery?

The human arm is comprised of three bones, the humerus, radius, and ulna. Ligaments hold these bones together and allow movement at the elbow and wrist. The ulnar collateral ligament (UCL), located inside the elbow, connects the humerus (the upper arm) to the ulna (the lower arm). When, because of repeated stress, the UCL tears, the player can no longer throw the baseball effectively.

In order to restore stability to the UCL, a tendon is taken from another part of the body. Usually, it is from the arm, leg, hip, or foot, and this autograft is then used to create a new UCL. (A tendon from a cadaver can also be used for the procedure.) Holes are drilled into the humerus and ulna bones and then, using a figure-eight pattern, the autograft is attached to the bones, creating a new UCL that is just as strong as the original.

Interestingly, many tendons in the human body, particularly the one attached to the palmaris longus muscle in the forearm, are not crucial for movement; therefore, many of them can be used as autografts in UCL reconstruction!

Recovery time from this operation takes from nine to 18 months, and the success rate is from 85 to 95 percent. Athletes from various sports have undergone UCL reconstruction, but most are pitchers in Major League Baseball. Minor League Baseball players and college players have also had the operation. Moreover, Miami Marlins pitcher Nathan Eovaldi had Tommy John surgery while he was a junior in high school!

Enter Tommy John

Back in 1974, Los Angeles Dodger left-handed starting pitcher Tommy John had a stellar record of 13 and 3 at the All-Star break, yet for some reason, he wasn’t selected for the All-Star team. Reputedly upset at being snubbed, he blew out his elbow in a subsequent game. (Players report hearing a “pop” when the elbow fails.) At this point, John found himself with the classic dead arm. Time to retire!

Then in September 1974, legendary surgeon, Dr. Frank Jobe proposed trying a new surgical procedure on John. John agreed to try it and underwent UCL reconstruction. John spent all of 1975 recovering from the operation.

During John’s recovery, teammate Mike Marshall, a right-handed closer for the Dodgers, taught John how to pitch without putting unnecessary stress on his pitching arm and both knees. This certainly helped with John’s rehabilitation process.

Now called “the Bionic Man,” John resumed his baseball career in 1976 and compiled a record of 10 and 10, considered a miraculous achievement by baseball experts. John continued pitching until 1989, winning another 164 games, one less than Koufax did in his entire career!

After that, UCL reconstruction has been dubbed by baseball enthusiasts as Tommy John surgery.

What Tommy John Thinks about Tommy John Surgery

Reacting to the recent rash of Tommy John surgeries in MLB, in May 2014 Tommy John said, "Throwing pitches in the big leagues will not hurt your arm," John told the Daily Times, as reported by ESPN. "It's what you did down the road when you were younger ... In essence, the injury itself is a buildup of overuse. And not overuse as an adult, but overuse as a kid.

"What I would like to see these guys do, these surgeons and all, is ask all the guys who have had the surgery: 'How much did you pitch as a kid and how often, and did you pitch year-round?' And nowadays, probably 70 to 80 percent of the pitchers today have been pitching 12 months a year since they were seven, eight, or nine years old. And your arm is not made for that."

Exit Hong-Chih Kuo

Major League relief pitcher Hong-Chih Kuo has the dubious distinction of being the MLB player with the most Tommy John surgeries – four! Kuo first blew out his left elbow in 2002, when he had two UCL reconstructions. And then in 2003, he had two more! Keep in mind; there’s never a certainty that the operation will be successful. Kuo wasn’t able to pitch effectively again until the 2005 season.

Nicknamed “Status Kuo” Kuo (pronounced “quo” as in quote) had an excellent year in 2010, making the All-Star team, while becoming the closer for the Los Angeles Dodgers. That year Kuo led all relief pitchers in the majors with an ERA of 1.20.

But Kuo’s career went downhill from there as he continued to struggle with elbow problems and an anxiety disorder. Kuo last pitched in the majors in 2011.

What about Jose Rijo?

According to the article “Tommy John Surgeries: A More Complete List,” on the website Beyondtheboxscore.com and last updated in November 2012, pitcher Jose Rijo may have had as many as five Tommy John surgeries, but the dates of these surgeries cannot be confirmed.

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Could another MLB pitcher break the TJ record?

Pitcher Brent Honeywell Jr. has had four elbow surgeries since 2018, two of which may have been Tommy John surgeries, though exactly what was done on each operation remains uncertain. Notably, in July 2024, Honeywell was claimed off waivers by the Los Angeles Dodgers.

Adding to Honeywell’s claim to fame, if you will, he throws a good fastball, as well as a wicked screwball, and at present seems the only MLB pitcher who throws that old-timey pitch made famous by hurlers such as Fernando Valenzuela of the LA Dodgers.

Emmet Sheehan is the latest LA Dodger to undergo Tommy John surgery.

How Many MLB Players Have Had Tommy John Surgery?

Per another article on the website Baseball Reference.com, last updated in January 2015, the list provided shows the names of 296 MLB players, active and retired, who have had Tommy John surgery. However, the author knew the name of at least one active player whose name should have been on this list, so the accuracy of this compilation is questionable. (By the way, this list shows that Jose Rijo did have five TJ surgeries.)

Moreover, the aforementioned website stated that at the time of Dr. Frank Jobe’s death in the spring of 2014, one-third of all MLB pitchers have had Tommy John surgery. It also stated that during the 2000s an average of 16 pitchers had the surgery each year. And, in 2012, a record 36 pitchers had the surgery!

According to an article on the website hardballtimes.com entitled “Major Leaguers’ Tommy John Surgeries Trending Down,” a total of 15 MLB players had Tommy John Surgery in 2016. This was a decrease from a total of 27 in 2015. The article suggested that the decrease was because some players chose less invasive procedures such as injections of stem cells or platelet-rich plasma. But the results of both treatments have been mixed at best.

Also, since 2019, some players have opted for having an internal brace added to their damaged UCL instead of replacing it with another tendon from the body, allowing for faster healing. This new technique may reduce recovery time for TJ surgery to 10 weeks, instead of 9 to 18 months for the classic TJ surgery.

Therefore, including data from a list found on Tommy John Surgery List @MLB Player Analysis, 32 MLB players had Tommy John surgery in 2021, and 28 had TJ surgeries in 2022 and 31 in 2023, making a grand total of 593 MLB players that have had TJ surgery since 1974.

The total for all baseball players who had TJ surgery in 2023 was 92, making a grand total of 2,365 TJ surgeries for players on all levels of baseball, including high school, college, all levels of minor league baseball, and, of course, MLB.

Whatever the total may be, it seems to change every week or two, especially during baseball season. Just hope your favorite player doesn’t need Tommy John surgery any time soon, if ever.

Comments

Tim on September 07, 2018:

Does anybody know the success rate of pitchers that come back from Tommy John compared to the failure rate? So out of 488 pitchers that had Tommy John, how many came back and actually pitched well compared to how many came back and failed?

Luke Giesbrecht on April 30, 2018:

This is a little bit late but can anybody find or come up with what percentage of Tommy John surgeries are performed on pitchers vs position players. Corey seager's recent injury got me thinking about this.

Kelley Marks (author) from Sacramento, California on November 18, 2014:

Thanks for the comment, GoldenRod LM. I'll have to update this story before the start of the 2015 season. Later!

John R Wilsdon from Superior, Arizona USA on November 18, 2014:

Glad I read this. Never followed up on what sports announcers were talking about when referencing Tommy John surgery. Amazing the things that can be done with ortho surgery.

Kelley Marks (author) from Sacramento, California on April 30, 2013:

Thanks for the comment, RonElFran, TJ surgery has saved the careers of many MLB pitchers. Later!

Ronald E Franklin from Mechanicsburg, PA on April 29, 2013:

Interesting hub. You frequently hear about Tommy John surgery without having any idea what it is. So, now I know. Thanks!

Kelley Marks (author) from Sacramento, California on October 18, 2012:

Thanks for the comment, andyglean. Just about every rotation has had some TJ surgery to go around. Later!

Andy Little from Richardson, TX on October 17, 2012:

I hope Neftali Feliz is another Tommy John Surgery success story. Our rotation could use the boost.

Kelley Marks (author) from Sacramento, California on September 01, 2012:

Thanks for the comment, Blackandgoldjack. Yes, now the Dodgers have a position player who's had Tommy John surgery. Too bad he can't play until next year! Later!

Jack Hazen from Blitzburgh area on August 30, 2012:

And now you have another Dodger who has had Tommy John surgery -- Carl Crawford. Although he had the surgery a couple days before he was traded to the Dodgers around a week ago.

Kelley Marks (author) from Sacramento, California on June 01, 2012:

Thanks for the comment, kathleenjusti. It's always good to hear from you.

Ditto for you, ShootersCenter, thanks for stopping by. Later!

David from Florida on June 01, 2012:

Good article with some interesting facts.

kathleenjusti on May 31, 2012:

Interesting article! Interesting information! Thank you for continuing to educate and inform.