Cain, Am J Sports Med 2010 - Outcome of Ulnar Collateral Ligament Reconstruction of the Elbow in 1281 Athletes

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Outcome of Ulnar Collateral Ligament Reconstruction of the Elbow in 1281 Athletes

Cain, Arthur, et al.·Am J Sports Med·2010·492 citations·Case series

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Background

The anterior bundle of the ulnar collateral ligament (UCL) is the primary anatomical structure providing elbow stability in overhead sports, particularly baseball. Injury to the UCL in overhead athletes often leads to symptomatic valgus instability that requires surgical treatment.

Purpose

Hypothesis: Ulnar collateral ligament reconstruction with a free tendon graft, known as Tommy John surgery, will allow return to the same competitive level of sports participation in the majority of athletes.

Methods

Study Design: Case series; Level of evidence, 4.

Ulnar collateral reconstruction (1266) or repair (15) was performed in 1281 patients over a 19-year period (1988-2006) using a modification of the Jobe technique. Data were collected prospectively and patients were surveyed retrospectively with a telephone questionnaire to determine outcomes and return to performance at a minimum of 2 years after surgery.

Results

942 patients were available for a minimum 2-year follow-up (average, 38.4 months; range, 24-130 months).
743 patients (79%) were contacted for follow-up evaluation and/or completed a questionnaire at an average of 37 months postoperatively.
617 patients (83%) returned to the previous level of competition or higher, including 610 (83%) after reconstruction.
The average time from surgery to the initiation of throwing was 4.4 months (range, 2.8-12 months) and the average time to full competition was 11.6 months (range, 3-72 months) after reconstruction.
Complications occurred in 148 patients (20%), including 16% considered minor and 4% considered major.

Conclusions

Ulnar collateral ligament reconstruction with subcutaneous ulnar nerve transposition was found to be effective in correcting valgus elbow instability in the overhead athlete and allowed most athletes (83%) to return to previous or higher level of competition in less than 1 year.

Copyright remains with the authors and publisher.

Outcome of Ulnar Collateral Ligament Reconstruction of the Elbow in 1281 Athletes

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Outcome of Ulnar Collateral Ligament Reconstruction of the Elbow in 1281 Athletes

Cain, Arthur, et al.·Am J Sports Med·2010·492 citations·Case series

|

Background

The anterior bundle of the ulnar collateral ligament (UCL) is the primary anatomical structure providing elbow stability in overhead sports, particularly baseball. Injury to the UCL in overhead athletes often leads to symptomatic valgus instability that requires surgical treatment.

Purpose

Hypothesis: Ulnar collateral ligament reconstruction with a free tendon graft, known as Tommy John surgery, will allow return to the same competitive level of sports participation in the majority of athletes.

Methods

Study Design: Case series; Level of evidence, 4.

Ulnar collateral reconstruction (1266) or repair (15) was performed in 1281 patients over a 19-year period (1988-2006) using a modification of the Jobe technique. Data were collected prospectively and patients were surveyed retrospectively with a telephone questionnaire to determine outcomes and return to performance at a minimum of 2 years after surgery.

Results

942 patients were available for a minimum 2-year follow-up (average, 38.4 months; range, 24-130 months).
743 patients (79%) were contacted for follow-up evaluation and/or completed a questionnaire at an average of 37 months postoperatively.
617 patients (83%) returned to the previous level of competition or higher, including 610 (83%) after reconstruction.
The average time from surgery to the initiation of throwing was 4.4 months (range, 2.8-12 months) and the average time to full competition was 11.6 months (range, 3-72 months) after reconstruction.
Complications occurred in 148 patients (20%), including 16% considered minor and 4% considered major.

Conclusions

Ulnar collateral ligament reconstruction with subcutaneous ulnar nerve transposition was found to be effective in correcting valgus elbow instability in the overhead athlete and allowed most athletes (83%) to return to previous or higher level of competition in less than 1 year.

Copyright remains with the authors and publisher.

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