03/09/11 6:52 PM ET
Peavy's surgery a first among baseball players
Righty underwent procedure usually performed on rock climbers
By Barry M. Bloom / MLB.com
2010 Spring Training - Chicago White Sox
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But he'll take it. Peavy is months ahead of schedule because of experimental surgery performed on his right shoulder by Dr. Anthony Romeo in Chicago this past July 14. Peavy completely ruptured the tendon that holds the latissimus dorsi muscle to the rear of the shoulder. The stitches and anchors now adhere the tendon to the bone.Romeo said that despite the dramatic and violent motion of a pitcher placing constant stress on the shoulder, there was little risk of any further damage. "There's no risk of [the anchors] coming out of the bone," Romeo said. "It can't happen. They have a reverse barb on them, like a fish hook. Once they go into the bone, you can't really pull them back out. They fill the bone, so there's not a weak spot in the bone anymore. There's no risk that even throwing a baseball is going to lead to a crack in the bone." Peavy is the first Major League starting pitcher to undergo this procedure, blazing the trail for others who will surely come after him. The surgical technique, devised only recently by Romeo, had previously been performed on other athletes such as wrestlers and rock climbers. The point can't be reiterated enough: no starting pitchers. "That injury has been diagnosed in pitchers before, but it's never been treated with surgical repair," Romeo said in an extensive phone interview from Chicago on Tuesday. "With Jake, we had the diagnosis right away. We knew what he had done, and it was our opinion that the most likely way he'd be able to come back long-term without any restrictions was to do the surgery." So far, so good. Peavy threw 26 pitches over the course of two scoreless innings this past Friday against the Angels at Tempe Diablo Stadium and left the mound on a high. On Monday, Peavy appeared to be merely content with another step in the process. To the observer, he appeared to be throwing free and easy like the Peavy who once dominated the National League, winning the Cy Young Award and the pitching Triple Crown in 2007 for the Padres. That year, Peavy led the NL with 19 wins, a 2.54 ERA and 240 strikeouts. On Monday, Peavy complained about a knot in his right hamstring and a certain amount of uneasiness as the ball came out of his hand. "I probably was more calm than I was the other day [against the Angels]," Peavy said. "I was more excited. Had a little more juices flowing. Today, I was just trying to weather the storm and get through it. I had a little hamstring tightness. We had that going on and wrapped up. My arm didn't feel great. I just didn't want to go out there and push it, push it, push it." If there's some creeping self-doubt, that would be natural. Romeo told Peavy that it might be a year from the surgery before he'd be back on the mound. He also warned Peavy that the surgery came with some risks: Because the tendon had snapped from the bone, the affected muscle had furled more than five inches from the original attachment site. To get to it, the incision couldn't be done arthroscopically, because of the location of the tendon and the real danger of nerve or blood vessel damage. Small incisions had to be made in two places, so the surgeons could grab the tip of the white tendon with a clamp. This is the most risky portion of the surgery, Romeo said, and it was accomplished through a one-inch incision. "There are very important nerves that go to the lower arm and hand that, if they were injured, he would not have been able to grip or throw a baseball," Romeo said. "So doing the surgery, we had to be very, very careful." Once that hurdle was passed, high-density polyester synthetic stitches were used to tie the tendon back to the bone using the anchors.
Romeo described those anchors as "like a molly bolt that is used for plaster, except that it has a little loop on the end of it."
He said that six stitches were tied to the loops of those three anchors -- two stitches attached to each anchor -- which are so tiny they individually fit into three, 3-millimeter holes.Peavy also has this going for him: Although he's experienced consistent shoulder problems throughout his nine-year career, there was no damage to the latissimus dorsi muscle, the rotator cuff, the labrum or any of the other critical functioning parts of the shoulder. "If that happened when I was playing," White Sox manager Ozzie Guillen said after Peavy's first start. "[He's] gone." Even five years ago, Peavy would've been a goner. Now, thanks to surgery Dr. Romeo performed on Jake Peavy, there's a decent chance it saved his career.
Barry M. Bloom is national reporter for MLB.com and writes an MLBlog, Boomskie on Baseball. Follow @boomskie on Twitter. This story was not subject to the approval of Major League Baseball or its clubs.