The New Yorker:

An elbow-injury epidemic has become an existential threat to the sport, prompting the M.L.B. to brainstorm new solutions, such as the use of a heavier ball.

By Lindsey Adler

Keith Meister, in the operating room of his private practice, draws a six-centimetre line on the elbow of a baseball pitcher. He slices the elbow open and stares into a mix of ligaments, tendons, and bone—any of which could be severely injured or disfigured. He pulls the player’s skin taut with a two-pronged retractor, then pulls out a modified arthroscopy camera and begins documenting the damage.

First, Meister assesses the severity of a suspected tear in the ulnar collateral ligament, one of the most important parts of a pitcher’s musculoskeletal system. He snaps a photograph for his data library. Then he uses a tendon, collected from the player’s wrist or thigh, to encase the U.C.L., taking more photos as he goes. To reinforce it further, Meister uses a two-millimetre-wide piece of synthetic braided fibre. The fibre looks like a shoelace. Meister positions it over the ligament and sews it along the length like an embroidery stitch. This technique, a combination of traditional Tommy John surgery—a procedure pioneered by Frank Jobe in the nineteen-seventies—and new technology, is known as a hybrid surgery.

“I take fifteen to twenty photographs of every case I do,” Meister said. “It’s helped me to go back and look at injury tear patterns and correlate them with the MRI scans. It’s certainly helped my own ability to see, evaluate, and treat some of these things in a more logical way.”

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