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BackgroundChronic elbow pain has several causes. Instability pain is one of the differential diagnosis. Posterolateral rotatory instability (PLRI) of the elbow results from lateral collateral ligament (LCL) insufficiency. This instability has been recognized in association with trauma of the elbow. The standard treatment of LCL insufficiency is ligament reconstruction with a tendon graft. Treatment outcome of LCL reconstruction in atraumatic PLRI cases has been rarely reported. This study reports the results of LCL reconstruction in patients with chronic lateral elbow pain from atraumatic PLRI.Materials and methodsData were collected from 36 patients referred to our institution for surgery because of chronic lateral elbow pain between November 2011 and June 2015. Six patients with atraumatic PLRI underwent LCL reconstruction with tendon graft. Demographic data, number of steroid injections, postoperative clinical examination, Mayo Elbow Performance Index, 11-item version of the Disabilities of the Arm, Shoulder and Hand score, and complications were recorded with a mean follow-up of 24 months.ResultsReconstruction resulted in significant improvement of pain. The mean postoperative Mayo Elbow Performance Index score was 97.5 (range, 95-100), and the score of the 11-item version of the Disabilities of the Arm, Shoulder, and Hand was 9 (range, 3.3-33). Postoperative instability test results were negative in all patients. Mean postoperative range of motion was 136° in flexion and 1° in extension. No complications were detected at the follow-up assessment.ConclusionsWe consider LCL reconstruction is one of the reference treatments for atraumatic PLRI because it provides effective and reliable results.

Objectives: The integrity of elbow soft tissues affects radiocapitellar joint stability in the presence of bipolar radial head (RH) prostheses. This study examined the effect on radiocapitellar stability of monopolar designs versus bipolar RH prostheses in an elbow model with a surgically controlled terrible triad injury.Methods: In each of 8 fresh-frozen elbow specimens (4 male and 4 female), a terrible triad fracture dislocation was created through soft tissue releases, coronoid fracture, and RH resection. Radiocapitellar stability was recorded under the following 3 sets of conditions: (1) surgical control (native RH), (2) RH replacement (circular monopolar or bipolar), (3) replacement with alternate circular RH not used in condition 2, and (4) replacement with the anatomic RH.Results: The type of RH used significantly impacted the mean peak force required to resist posterior subluxation (p = 0.0001). The mean peak subluxation force of the bipolar prosthesis (1 6 1 N) was significantly less than both the anatomic (16 6 1 N) and nonanatomic circular (12 6 1 N) implants (p = 0.0002). The peak subluxation force of the native RH (18 6 2 N) was not different than the anatomic implant (p = 0.09) but was greater than the nonanatomic circular design (p = 0.0006).Conclusions: Monopolar RHs confer greater radiocapitellar stability than bipolar implants in the setting of terrible triad injuries.Of the 2 monopolar designs tested, the anatomic design provided more stability than the non-anatomic RH prosthesis.