Purdy will need to have surgery to repair UCL
Brock Purdy’s elbow injury brought the 49ers’ Super Bowl LVII hopes crashing down, and the still-unknown severity of his ligament tear could go a long way toward determining their chances of reaching next February’s edition.
Purdy will need surgery to repair his ulnar collateral ligament, and the 49ers are optimistic Purdy’s path to recovery could take only six months.
Former 49ers backup Nick Mullens is the lone NFL quarterback known to have a torn ulnar collateral ligament repaired with an internal brace. That came after an injury he sustained in the 49ers’ penultimate game of the 2020 season.
Mullens’ comeback tour has taken him to four teams — the Browns, Eagles, Raiders and Vikings — over the past two years.
Purdy continued to seek medical opinions the first few days after his opening-series injury on Sunday, and the consistent feedback is that the 23-year-old likely will undergo a repair, general manager John Lynch said Wednesday. However, a UCL replacement, also known as Tommy John surgery, can’t be completely ruled out yet.
The ultimate decision could come mid-operation when the surgeon can closely examine the ligament.
“The positive bit of news is that it seems to be consistent that the right approach is the one that takes us to the six-month mark,” Lynch said. “Everyone will also say, you never know once you get in there. Every surgeon will tell you that on every surgery, you need to get in to see exactly.”
Dr. Nirav Pandya, a pediatric orthopedic surgeon at UCSF, isn’t surprised by this diagnosis. That Purdy was gingerly throwing the football on the sideline — and later able to throw a handful of wobbly emergency passes once backup Josh Johnson left the game with a concussion — is a good indication that Purdy’s UCL is in decent shape despite the tear. Pandya said he would be shocked if surgeons determined that Purdy needed a UCL replacement.
“He has so much less mileage on his elbow, so that works in his favor,” Pandya said. “He probably has good cartilage and muscles. It’s never a good time for surgery, but the fact it’s during his first year is a good sign.”
If Purdy undergoes a repair, he will likely be able to start throwing a ball again after three months and return to action after six months, “so you have May to August to get back to your mechanics and iron out details,” Pandya said.
Mullens, when reached by the Bay Area News Group, preferred not to detail his surgery or recovery, but did state: “The UCL repair internal brace surgery allowed me to get back on the field faster than Tommy John surgery. I couldn’t afford to miss a whole year with Tommy John so I’m thankful for the internal brace.”
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Tommy John surgery would force Purdy out for 9-to-12 months, but it is common among athletes with far more wear and tear on their elbows.
Baseball pitchers, including the eponymous Tommy John himself, have typically needed the surgery because they use that ligament to get torque on their pitches, repeatedly thrown at high velocity. Jake Delhomme, formerly of the Panthers, is the only NFL quarterback known to have had Tommy John surgery, and he had a record of elbow pain and injuries.
A UCL repair is far less invasive and would give Purdy plenty of time to rehab his elbow in time for the 2023 season. He and Trey Lance will likely be competing for the starting quarterback job, coach Kyle Shanahan told reporters on Wednesday.
“I know we have two starters on our team right now that I believe we can win with,” Shanahan said. “So when you have that situation, you’re not that eager to go looking around.”