Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Jan 25;5(1):2325967116682211.
doi: 10.1177/2325967116682211. eCollection 2017 Jan.

Treatment of Ulnar Collateral Ligament Tears of the Elbow: Is Repair a Viable Option?

Brandon J Erickson  1 , Bernard R Bach Jr  1 , Nikhil N Verma  1 , Charles A Bush-Joseph  1 , Anthony A Romeo  1
Affiliations

Treatment of Ulnar Collateral Ligament Tears of the Elbow: Is Repair a Viable Option?

Brandon J Erickson et al. Orthop J Sports Med. .

Abstract

Background: Ulnar collateral ligament (UCL) tears have become common, and UCL reconstruction (UCLR) is currently the preferred surgical treatment method for treating UCL tears.

Purpose/hypothesis: The purpose of this study was to review the literature surrounding UCL repair and determine the viability of new repair techniques for treatment of UCL tears. We hypothesized that UCL repair techniques will provide comparable results to UCLR for treatment of UCL tears.

Study design: Systematic review and meta-analysis; Level of evidence, 4.

Methods: A systematic review was registered with PROSPERO and performed with PRISMA guidelines using 3 publicly available free databases. Biomechanical and clinical outcome investigations reporting on UCL repair with levels of evidence 1 through 4 were eligible for inclusion. Descriptive statistics were calculated for each study and parameter/variable analyzed.

Results: Of the 46 studies eligible, 4 studies (3 clinical and 1 biomechanical) were included. There were 92 patients (n = 92 elbows; 61 males [62.3%]; mean age, 21.9 ± 4.7 years) included in the clinical studies, with a mean follow-up of 49 ± 14.4 months. Eighty-six percent of repairs performed were on the dominant elbow, and 38% were in college athletes. Most UCL repairs (66.3%) were performed via suture anchors. After UCL repair, 87.0% of patients were able to return to sport. Overall, 94.9% of patients scored excellent/good on the Andrews-Carson score. Patients who were able to return to sport after UCL repair did so within 6 months after surgery. Biomechanically, when UCL repair was compared with the modified Jobe technique, the repair group showed significantly less gap formation than the reconstruction group.

Conclusion: In patients for whom repair is properly indicated, UCL repair provides similar return-to-sport rates and clinical outcomes with shorter return-to-sport timing after repair compared with UCL reconstruction. Future outcome studies evaluating UCL repair with internal bracing are necessary before recommending this technique.

Keywords: Tommy John; baseball; pitcher; repair; ulnar collateral ligament (UCL); ulnar collateral ligament reconstruction (UCLR).

PubMed Disclaimer

Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: B.R.B. receives research support from Arthrex Inc, CONMED Linvatec, DJ Orthopaedics, Ossur, Smith & Nephew, and Tornier. N.N.V. receives research support from Arthrex Inc, Arthrosurface, DJ Orthopaedics, Smith & Nephew, Athletico, ConMed Linvatec, Miomed, and Mitek; has stock or stock options in Cymedica, Minivasive, and Omeros; is a paid consultant for Minivasive, Orthospace, and Smith & Nephew; and receives royalties from Smith & Nephew. C.A.B. has stock or stock options in Cresco Lab and is an unpaid consultant for The Foundry. A.A.R. receives research support from DJO, Ossur, Smith & Nephew, and Arthrex Inc and receives IP royalties and is a paid consultant for Arthrex Inc.

Figures

Figure 1.
Figure 1.
Systematic review search algorithm according to PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines. After application of all exclusion criteria, 4 studies were identified for inclusion and further analysis. LCL, lateral collateral ligament; PLRI, posterolateral rotary instability; UCLR, ulnar collateral ligament reconstruction.
See this image and copyright information in PMC

References

    1. Andrews JR, Jost PW, Cain EL. The ulnar collateral ligament procedure revisited: the procedure we use. Sports Health. 2012;4:438–441. - PMC - PubMed
    1. Argo D, Trenhaile SW, Savoie FH, 3rd, Field LD. Operative treatment of ulnar collateral ligament insufficiency of the elbow in female athletes. Am J Sports Med. 2006;34:431–437. - PubMed
    1. Azar FM, Andrews JR, Wilk KE, Groh D. Operative treatment of ulnar collateral ligament injuries of the elbow in athletes. Am J Sports Med. 2000;28:16–23. - PubMed
    1. Bruce JR, Andrews JR. Ulnar collateral ligament injuries in the throwing athlete. J Am Acad Orthop Surg. 2014;22:315–325. - PubMed
    1. Cain EL, Jr, Andrews JR, Dugas JR, et al. Outcome of ulnar collateral ligament reconstruction of the elbow in 1281 athletes: results in 743 athletes with minimum 2-year follow-up. Am J Sports Med. 2010;38:2426–2434. - PubMed

LinkOut - more resources