A Systematic Review of Ulnar Collateral Ligament Reconstruction Techniques

Watson, Jonathan N.; McQueen, Peter; Hutchinson, Mark R.

doi:10.1177/0363546513509051

Cited by 118 publications

(101 citation statements)

References 26 publications

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“…12 The most common complication is ulnar nerve neuropraxia, which can be seen in approximately 10% of cases. Different techniques have been described for the approach to the flexor-pronator mass, location of humeral tunnels, choice of graft fixation, and performance of an ulnar nerve transposition.…”

Section: Discussionmentioning

confidence: 99%

“…In a recent systematic review comparing UCL reconstruction techniques, the docking technique resulted in a significantly higher rate of return to play (90.4% vs 66.7%) and a lower complication rate (6.0% vs 29.2%) when compared with the Jobe and modified Jobe techniques. 12 In a biomechanical comparison of fixation methods, the docking technique had a significantly higher load to failure compared with Jobe and interference screw techniques 13 (Table 2). Our technique has advantages and disadvantages.…”

Section: Discussionmentioning

confidence: 99%

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Modified Jobe Approach With Docking Technique for Ulnar Collateral Ligament Reconstruction

Kaplan

Glait

Ryan

et al. 2016

Arthroscopy Techniques

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The ulnar collateral ligament (UCL) of the elbow acts as the primary restraint to valgus force experienced in the late cocking and early acceleration phases of overhead throwing. If the UCL or dynamic flexor-pronator musculature is incompetent, elbow extension and valgus torque, as seen in throwing, can result in posteromedial impingement with subsequent chondromalacia and osteophyte formation. Before the first UCL reconstruction, performed by Frank Jobe in 1974, this injury was considered career ending in overhead athletes. Since the index procedure, further techniques have been developed to minimize dissection of the flexor-pronator mass and improve the biomechanical strength of graft fixation with the goal of increased return to athletic competition. We describe our techniquedincluding pearls and pitfalls, as well as advantages and disadvantagesdwhich combines the docking technique, through a flexor muscle-elevating approach with transposition of the ulnar nerve using a fascial sling. Harvest and preparation of a palmaris longus tendon autograft is also described.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Modified Jobe Approach With Docking Technique for Ulnar Collateral Ligament Reconstruction

Kaplan

Glait

Ryan

et al. 2016

Arthroscopy Techniques

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“…25,27 A curvilinear incision posterior to the medial epicondyle is made, and the medial antebrachial cutaneous branches are protected. The ulnar nerve, which is identified running between the 2 heads of the flexor carpi ulnaris (FCU), is also carefully protected.…”

Section: Surgical Techniquementioning

confidence: 99%

Ulnar Collateral Ligament Reconstruction; the Rush Experience

Erickson¹,

Bach²,

Cohen³

et al. 2016

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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“…While the improved surgical options have, indeed, translated to improved functional and patient outcomes, the treatment algorithm for MUCL tears remains elusive. Hurwit et al surveyed 159 members of the American Shoulder and Elbow Surgeons and reported that professional athletes and those with complete tears were indicated for surgery by consensus; opinion was more divided on how to treat partial tears or non‐professional athletes.…”

Section: Introductionmentioning

confidence: 99%

Conservative Versus Surgical Management of Elbow Medial Ulnar Collateral Ligament Injury: A Systematic Review

Biz

Crimì

Belluzzi

et al. 2019

Orthopaedic Surgery

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ObjectiveSeveral studies have been published regarding the treatment of medial ulnar collateral ligament (MUCL) injuries for professional overhead athletes. However, there is a paucity of data regarding non‐professional athletes. The aim of this systematic review was to compare the rate of outcome scores and complications of conservative versus operative treatments both in non‐professional athletes and in non‐sport‐related trauma patients with MUCL lesions.MethodsA systematic review of the published literature was performed by applying the PRISMA guidelines. A search was conducted using three databases: Medline, Science Direct, and Web of Science. The keywords used were “ulnar collateral ligament injury,” “elbow,” “surgery,” and “conservative treatment”. Patients were divided into three groups: patients who underwent conservative treatment (C‐group), surgical treatment (S‐group), and surgery after a failed conservative treatment (C&S‐group). Clinical outcomes were analyzed: Disability of Arm, Shoulder and Hand (DASH), Conway scale, Carson score, and Kerlan–Jobe Orthopaedic Clinic score (KJOC).ResultsA total of 15 studies were included, evaluating 513 patients. Although good and excellent outcomes were found for most patients during daily and/or sport activities, independently of the type of treatment, the C‐group had better results. Excellent results were found in 98.8% of the C‐group, in 88.1% of the S‐group, and in 87.7% of the C&S‐group. The complication rate in the C‐group was statistically higher compared to the S and C&S groups (P < 0.001). However, its complication rate was higher with lower patient satisfaction.ConclusionsThere is insufficient evidence to establish statistically significant differences in the effects of conservative versus surgical treatments on the functional outcomes of patients with MUCL lesions. However, a period of rehabilitation therapy and the functional request of the single injured subject are useful to discern which patients genuinely require MUCL surgical repair.

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A Systematic Review of Ulnar Collateral Ligament Reconstruction Techniques

Abstract: A lower complication rate can lead to increased rates of return to play and better outcomes postoperatively.

Cited by 118 publications

References 26 publications

Modified Jobe Approach With Docking Technique for Ulnar Collateral Ligament Reconstruction

Modified Jobe Approach With Docking Technique for Ulnar Collateral Ligament Reconstruction

Ulnar Collateral Ligament Reconstruction; the Rush Experience

Conservative Versus Surgical Management of Elbow Medial Ulnar Collateral Ligament Injury: A Systematic Review

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