Biomechanical Evaluation of the Docking Plus Ulnar Collateral Ligament Reconstruction Technique Compared With the Docking Technique

Abstract

The docking plus technique allows greater stiffness and a higher moment to failure immediately after reconstruction and describes a way to maintain constant graft tension during fixation, resulting in a biomechanically stronger UCL reconstruction.

Rate of Return to Pitching and Performance After Tommy John Surgery in Major League Baseball Pitchers

“…5,11,14,15 A correlation between superior biomechanical performance and clinical/level of play performance, however, has yet to be fully elucidated.…”

Computing Muscle, Ligament, and Osseous Contributions to the Elbow Varus Moment During Baseball Pitching

“…increased the joint compression force) and decreased the load on the UCL (Figure 9). Without muscle-tendon actuation, the magnitude of the external load supported by the UCL was computed to be 330% of its reported failure load of 35 Nm, 28 highlighting the vital role of muscle-tendon contributions to reducing UCL injury risk.…”

“…6,13 For the UCL to produce a varus moment it must support an elevated level of tension relative to its typical state when the elbow is unloaded in varus-valgus and this tension puts the ligament in danger of failing. 28 Research in cadavers has shown that tension in the UCL can be reduced by increasing tension in the medial elbow muscles. 24,37,40 Examinations of elbow physiology in vitro have also revealed that muscle contraction generates joint compression.…”

Comparison of Ulnar Collateral Ligament Reconstruction Techniques in the Elbow of Sports Players

“…Bower et al [14] described another three-strand docking technique with excess graft sutured to the anterior band, while tension was maintained on the excess graft. McGraw et al [15] and Donohue et al [16,17] reported a novel docking plus technique that used four strands of the palmaris longus tendon.…”