Anconeus-Sparing Minimally Invasive Approach for Lateral Ulnar Collateral Ligament Reconstruction in Posterolateral Elbow Instability

Voß, Andreas; Greiner, Stefan

doi:10.1016/j.eats.2019.10.013

Cited by 5 publications

(3 citation statements)

References 8 publications

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“…aInsertionoftheloadedcortical button through the monocortical thrill hole at the ulnar isometry center on the supinator crest.b Graft tunneling between the fascia, the anconeus muscle, and the capsule toward the lateral epicondyle.c Humeral fixation of the augmented graft on the humeral isometry center using a suture anchor common extensor origin, preservation of preexisting LUCL fibers, and a high rate of restored elbow stability. Recently, a similar procedure with a minimally invasive approach was described by Voss and Greiner [7]. In this paper, however, we opted for a modified Kocher approach for a better overview when shuttling the graft.…”

Section: Discussionmentioning

confidence: 99%

Lateral ulnar collateral ligament reconstruction of the elbow using a triceps tendon autograft—a technical note

et al. 2022

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Section: Discussionmentioning

confidence: 99%

Lateral ulnar collateral ligament reconstruction of the elbow using a triceps tendon autograft—a technical note

et al. 2022

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“… 1 , 22 , 33 Therefore, in the posture where the elbow is bent about 90 degrees, using the anconeus tendon as a guide leading to the humeral insertion of the LUCL and probing the posterolateral joint capsule through the Kocher interval to refer to the imaginary circumference of the capitellar hemicircle and the location of the radiocapitellar joint, the isometric point of the humeral tunnel can be determined without difficulty. 6 , 46 Additional two small holes were formed in the posterior cortex of the humerus using a 2.0-mm K-wire in a Y-shape toward the humeral tunnel. The semitendinosus allograft tendon was split to make it to a thickness sufficient to barely pass through a 3.5 mm hole and pulling threads were made via whipstitches on one end so that a loop was formed by first passing the bone tunnel of the ulna.…”

Section: Methodsmentioning

confidence: 99%

Lateral ulnar collateral ligament (LUCL) reconstruction for the treatment of recalcitrant lateral epicondylitis of the elbow: a comparison with open débridement of the extensor origin

et al. 2021

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Background Based on the controversy over whether the extensor tendon is the only lesion of lateral epicondylitis of the elbow and numerous reports of concomitant lateral collateral ligament involvement, potential damage to the lateral collateral ligament complex should be considered for the treatment. Methods About 25 elbows in 23 patients (débridement group) and 22 elbows in 20 patients (reconstruction group) who were diagnosed with lateral epicondylitis and had an average of 22 months of symptoms revealing anatomical lesion on MRI were included. The capitellum-sublime tubercle-radial head (CSR) angle was measured on both sides preoperatively, and the visual analog scale (VAS) and Mayo elbow performance score (MEPS) were measured over 12 months, postoperatively. Results The initial preoperative mean VAS was statistically significant with 4.6 in the débridement group and 6.5 in the reconstruction group ( P < .05). Postoperative VAS was continuously decreased in both groups with no significant difference at each assessment period ( P < .05) but showed more rapid improvement in the reconstruction group compared with the débridement group. For MEPS, the reconstruction group showed significant improvement during the follow-up periods, and at the final follow-up MEPS, 3 cases in the débridement group and 0 cases in the reconstruction group showed a poor result, which was considered as surgery failure. The CSR angle of the affected side (7.2 ± 1.9) was significantly larger than that of the normal side (3.6 ± 1.5) ( P < .05) in the reconstruction group. Increased CSR by more than 5 degrees was identified as a significant predictive indicator for potential concomitant ligament insufficiency (area under curve = 0.875, P < .001) showing 80.9% of the sensitivity, 82.1% of the specificity. Conclusions In the surgical treatment of recalcitrant lateral epicondylitis, lateral ulnar collateral ligament reconstruction added to the débridement of extensor origin may provide better results for the patients with suspicious lateral ligament insufficiency or failed previous surgery.

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“…In recent years, there has been a shift toward techniques with minimal soft tissue and joint disruption. 30 Elbow arthroscopy plays an important role in this, and has been shown to be an excellent technique to accurately diagnose and manage these lesions. In patients presenting with acute instability, arthroscopy can be used to repair ligaments, and associated intra-articular bone or cartilage lesions can be evaluated and addressed at the same time.…”

mentioning

confidence: 99%

The role of arthroscopy in instability of the elbow

Pierreux¹,

Caekebeke²,

Riet³

2023

JSES International

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Anconeus-Sparing Minimally Invasive Approach for Lateral Ulnar Collateral Ligament Reconstruction in Posterolateral Elbow Instability

Cited by 5 publications

References 8 publications

Lateral ulnar collateral ligament reconstruction of the elbow using a triceps tendon autograft—a technical note

Lateral ulnar collateral ligament reconstruction of the elbow using a triceps tendon autograft—a technical note

Lateral ulnar collateral ligament (LUCL) reconstruction for the treatment of recalcitrant lateral epicondylitis of the elbow: a comparison with open débridement of the extensor origin

The role of arthroscopy in instability of the elbow

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