Is Tommy John surgery becoming more prevalent in top prospects?

While torn ulnar collateral ligaments have perhaps been surpassed by thoracic outlet syndrome as the most devastating injury to pitchers, that’s probably only because Tommy John surgery—and its success stories—has become far more mainstream as the years have gone on. With the draft nearing, we at MLBDD wonder: how often Tommy John surgery being performed on top prospects and draftees as compared to years past?

Fortunately for us, there’s only one webpage we have to visit to find out all of this pertinent information. Jon Roegele (@MLBPlayerAnalys) of Fangraphs and The Hardball Times has maintained his indispensable Tommy John Surgery List for a few years now, and it now includes over 1500 surgeries, from the very first in 1974 all the way to Angels reliever Keynan Middleton’s on Tuesday. I took a deep dive to see how top prospects have fared in recent years.

In 2018 we’ve already seen eight pitchers who are top 30 prospects in their organizations (as ranked by MLB.com) undergo Tommy John surgery, with their organizational ranking in parentheses:

A.J. Puk, A’s (1st)
Brent Honeywell, Rays (1st)
Jay Groome, Red Sox (2nd)
Cole Ragans, Rangers (5th)
Julian Merryweather, Cleveland (16th)
Bryan Garcia, Tigers (16th)
Matt Givin, Marlins (23rd)
Dalton Sawyer, A’s (26th)

That’d put us on pace for roughly twenty top-30 prospects to go under the knife at some point in this calendar year. Last year there were 21 players who were top-30 prospects at the end of the 2017 season undergo Tommy John surgery, with the most prominent names including Yankees infielder Gleyber Torres, Twins outfielder Alex Kiriloff and Padres righty Anderson Espinoza (interestingly enough, none of the 2018 top prospects have been position players). So, if we’re exclusively looking at ranked prospects currently in major league organizations, the answer is no, Tommy John surgery isn’t becoming more prominent. But how about amongst those who could eventually make their way into the professional ranks?

Roegele’s list has a handy “D1 Colleges” tab, so I simply counted up how many Division I prospects have had Tommy John surgery each year, and here’s what I found (keep in mind that Roegele’s list is incomplete, especially at the college level):

2018: 18 (on pace for about 43)
2017: 59
2016: 61
2015: 45

The answer here to our question also appears to be “no,” though I do wonder if upcoming conference tournaments and the College World Series will cause pitchers to have higher pitch counts than usual, pushing their arms to the limit and unfortunately increasing that pace that now sits at 43 for year.

This all jibes with Travis Sawchik’s findings on Fangraphs in January, where he noted that Tommy John surgery prevalence has declined since 2015, with under 100 known surgeries being performed on professional players—including position players—in 2017 (96 surgeries) for the first time since 2011. That number is on pace to decrease even further this year, as this year’s rate of surgeries currently extrapolates out to a projection of just 87 surgeries in pro baseball through the end of 2018. And with fewer surgeries overall comes fewer surgeries for top prospects, robbing us of fewer breakout seasons from top prospects, and, more important, robbing fewer top prospects of 12+ months of their baseball careers.