Noah Syndergaard to have Tommy John surgery, but does it need to happen quickly?

A part of the U.S. population believes professional sports leagues are receiving preferential treatment during the coronavirus pandemic. Players and other team personnel have been tested for COVID-19 in an expedited manner while a majority of Americans still cannot get the tests.
 
People are also questioning whether it’s appropriate for surgeons to operate on injured MLB pitchers when hospitals are being overtaxed by ill patients and some states are prohibiting non-essential procedures.

The Mets’ announcement Tuesday that right-hander Noah Syndergaard would undergo ligament replacement surgery, aka Tommy John surgery, on Thursday to repair a UCL tear in his pitching elbow provided more debate fodder. Syndergaard joined the Yankees’ Luis Severino, the Red Sox’s Chris Sale and the Giants’ Tyler Beede in being recommended for the procedure since the start of spring training.

An orthopedic surgeon who has extensive experience with Tommy John surgeries — and who provided Beede and Syndergaard with second opinions — argued that the procedures aren’t elective because delays can harm a pitcher’s earning potential.

“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 told the San Francisco Chronicle’s Henry Schulman (subscription required) as he discussed Beede’s case. ElAttrache is a team physician for the Dodgers and the NFL’s Rams.

“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,” he told Schulman.

Tommy John surgery requires a rehab period of 12 to 18 months. Beede and Syndergaard are expected to return to the mound during the 2021 season.

Beede had his surgery last week in Texas; Syndergaard will have his operation in Florida, where Gov. Ron DeSantis issued an executive order last week prohibiting “any medically unnecessary, non-urgent or non-emergency procedure or surgery which, if delayed, does not place a patient’s immediate health, safety, or wellbeing at risk, or will, if delayed, not contribute to the worsening of a serious or life-threatening medical condition.”

New York Gov. Andrew Cuomo has likewise canceled “all elective, non-critical surgeries” in his state beginning Wednesday. The New York Post’s Mike Puma wrote in a pair of tweets that the Mets regard Syndergaard’s procedure as essential and that the severity of the pitcher’s injury puts it in that category.

ElAttrache told Schulman that the Kerlan-Jobe Institute in California, where he practices, has reduced the number of its Tommy John surgeries by about 90 percent during the coronavirus pandemic and that an internal panel is reviewing cases to determine which are the most time-sensitive.

Schulman noted that while Kerlan-Jobe and the other clinics that do these surgeries are private, people believe that equipment used in the procedures could be sent to public hospitals, which are being taxed by COVID-19 cases. ElAttrache told Schulman that Kerlan-Jobe would halt orthopedic surgeries if a public-health need arises.

ElAttrache also pushed back on the perception that teams and leagues are using their prestige (and cash) to secure medical assistance ahead of other people.

“Whether it’s a kid losing a scholarship, or a man who has to work (his arms) overhead because he has his own air-conditioning business, or a player making money on a good contract, if somebody’s livelihood is at stake, I’m blind to the name of the companies they work for,” he told Schulman. 

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