80 Percent Failure?

Yesterday, after writing about Tommy John revisions (or second Tommy John surgery), someone pointed out to me that Dr. James Andrews had been quoted as saying that the failure rate for revisions was about 80 percent.

That’s pretty high. I simply couldn’t figure out where that came from and did some research. I had nine current players who had returned from a second TJS during the 2013 season. All successfully returned, under the definition that getting back to MLB is success. It says nothing of effectiveness.

A number of people started to do further research, including Jon Roegele (@mlbplayeranlys). He found a total of 26 players who had returned, 8 who did not return and 8 who have not had sufficient time to return yet. (I’m not sure if that includes recent players like Kris Medlen and Jarrod Parker.) Check Jon’s timeline for more details.

So what was Dr. Andrews talking about? I’m not sure. My guess is that Jim is including lower level pitchers. It’s known that lower level pitchers often walk away from rehab for one reason or another. A high school kid decides that maybe he doesn’t want to do a year of hard work and instead will focus on playing guitar (A case I know about.) The success rate for Tommy John surgery overall is somewhere between 75 and 88 percent, depending on the study you read.

There’s not enough public numbers when it comes to lower level pitchers to know more about their rate, especially when it comes to revisions. Even at the MLB level, we’re piecing things together with unconfident data. I want to be clear that I’m not doubting Andrews’ statement, just that I’m not sure what the basis of it is. I’ve reached out to his people for comment and will update this once I know more.

I’ve also reached out to the other major TJ surgeons - Tim Kremchek, Neil ElAttrache and David Altcheck - for similar comment and insight. Again, I’ll add here if I get more from them.

Currently, I do not believe my piece stating that Medlen and Parker could be expected to return is undermined by the Andrews quote. As always, my position is based on current knowledge and if I am proved incorrect, I will gladly update my position.