Ohtani's fast recovery is a testament to the revolutionary procedure, originally performed 50 years ago on another Dodgers pitcher.
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With that powerful arm, Ohtani displays control, command and speed. His throwing skills rose to new heights after a 2018 surgery to repair a torn elbow ligament.
"Within two years after his Tommy John operation, he was throwing well over 100 mph. And then last March, about a year ago, he was clocked at over 100 to 103 mph," said Dr. Neal ElAttrache.
He performed that surgery while Ohtani played for the Angels. As the Dodgers' head team doctor, ElAttrache looked on with admiration, but also concern.
"Those are the times when we get worried. Those are new forces that the body is going to have to withstand that we don't know how that's gonna go," he said.
Ohtani's ligament did tear again. In September, ElAttrache performed a Tommy John revision on Ohtani's right elbow. Despite that, interest in the two-way star didn't wane. Many teams besides the Dodgers offered him colossal multi-year deals.
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"The sport is willing to invest enormous amounts of money in these players," said ElAtrrache, chairman of the Kerlan-Jobe Foundation.
He trained under Dr. Frank Jobe who pioneered the surgery and named it after his first patient, Tommy John. The Dodgers pitcher retired at age 46 after 26 MLB seasons. Jobe perfected the procedure at Rancho Los Amigos, repairing and replacing tendons of disabled children.
"To make them take the place of other tendons and muscles that are otherwise paralyzed or damaged," ElAttrache said.
The ulnar collateral ligament keeps the elbow hinge stable. But when pitchers throw, it unlocks the hinge putting incredible force on the fibrous tissue. Doctors replace it with a donor graft usually taken from the forearm or hamstring.
"About 25% of all pitchers in Major League Baseball will have had or will need the Tommy John operation," he said.
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ElAtrrache describes Ohtani's second procedure as a hybrid one involving an internal brace and some fancy suturing.
"I would weave the suture in the good part of the ligament. And so that would pull it tight. And then repair it," said ElAttrache.
As a left-handed hitter, Ohtani is off to a strong start with the Dodgers. Dr. ElAttrache says being able to see athletes return and do well is the greatest reward. But when Ohtani takes the mound again this fall, the idea of reliving an historic event is not lost on him.
"Very ironic that it's happening to a Dodger pitcher in Los Angeles, 50 years to the date of the first Tommy John surgery. I'll be just as interested as anybody else in September," said ElAttrache.