He'd thrown thousands of pitches over the past 12 years. Thousands of fast balls, sliders, change-ups and curveballs. But this one, this single strike, felt different.
Josh Bortka recounts it this way: “The first inning went great. The second was OK. In the third, I threw a strike, but the release felt really slow. Instantly, my hand and pinky started tingling, and my forearm got tight. Coach took me out of the game. Something wasn't right.”
Josh has played baseball since he was 5. In his early years, he also played football – like many kids, a year-round athlete. But at age 14, he decided to focus on the mound. By his junior year, he was ranked No. 3 in the state of Kansas as a right-handed pitcher for Perfect Game. At 17, he continued playing in a competitive league, electing to no longer play for his high school. He was poised for a college career.
Then, injury. Josh's chiropractor reached out to his connections at the Kansas City Royals organization and got Josh a referral to sports medicine specialist Vincent Key, MD, of The University of Kansas Health System.
Evaluating the best treatment option
“Josh's main complaint was pain in his elbow, but his command of pitches and his velocity were noticeably dropping,” says Dr. Key.
An MRI showed the ulnar collateral ligament (UCL) in Josh's pitching arm had detached from the humerus bone.
“When I saw Josh, we talked about both Tommy John surgery and a repair and bridge of the UCL,” says Dr. Key. “A lot of considerations go into choosing between Tommy John, which is a reconstruction, and the UCL repair and bridge. My ultimate decision factors are, first, where the tendon is torn, and second, how old the patient is.”
Josh's scenario checked all the boxes that made UCL repair and bridge a great option. This procedure offers a recovery time of 6-9 months, significantly less than the typical 12-14 months required to come back from Tommy John surgery. In the Tommy John procedure, doctors use another tendon in the arm or hamstring to reconstruct the damaged tendon. With the less invasive UCL repair and bridge, the tear in the damaged tendon is repaired and a special tape used to reinforce the ligament.
UCL repair and bridge surgery is a relatively new procedure with little long-term data available, but post-operative results thus far are promising.
“Professional athlete have an 80 percent likelihood of coming back to their full pre-injury performance level,” Dr. Key says. “The same is true for high school athletes – an 80 percent chance of hitting the reset button to where they were performing before the injury. The potential from there is on the player.”
Josh appreciated Dr. Key's experience with athletes and the treatment options to consider.
“He shared his confidence in the UCL repair and bridge, along with stories of other surgeries he'd done for professional players,” says Josh. “It gave me a level of comfort and trust in him, and it made me want to learn more about the UCL surgery. I went home and watched videos and got a better understanding of the procedure.”
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From August 28 to November 20, walk-in care will be available 8-11 a.m. Saturdays at the Sports Medicine and Performance Center located at 10730 Nall Ave., Suite 200, in Overland Park. Additionally, extended weekday hours allow you to make appointments with a physician until 7 p.m. Monday-Thursday for orthopedic injuries. Learn more https://www.kansashealthsystem.com/news-room/news/2021/07/sports-medicine-extended-hours