Biomechanics of a Less Invasive Procedure for Reconstruction of the Ulnar Collateral Ligament of the Elbow

Abstract

A reconstruction of the anterior bundle of the ulnar collateral ligament of the elbow using bone anchors was compared regarding strain and valgus load strength with the intact ulnar collateral ligament and the reconstructed ulnar collateral ligament using bone tunnels. In both normal and reconstructed elbows, the anterior band and posterior band were tight during only a portion of the range of motion. Toward extension, the mean peak strain in the anterior band was tight for the normal and bone anchor groups, but lax in the bone tunnel group. Toward extension, the mean peak strain in the posterior band was lax in all elbows. Toward flexion, the strain in the anterior band was lax in the normal and bone anchor groups, but tight in the bone tunnel group. The mean of the peak strains for the posterior band toward flexion was tight for all elbows. Mean valgus load strength of normal elbows was 22.7 +/- 9.0 N.m. The bone tunnel and bone anchor mean strengths were 76.3% and 63.5%, respectively, of normal elbow strength. We concluded that the bone anchor reproduced the normal anatomy and mechanical function of the ulnar collateral ligament more closely than the bone tunnel, and that both reconstruction methods were significantly weaker than the normal ulnar collateral ligament. However, we found no significant difference in reconstruction strength between bone anchor and bone tunnel.

The impact of ulnar collateral ligament tear and reconstruction on contact pressures in the lateral compartment of the elbow

“…1,18,20,35,39,41 Of these, biomechanical testing has demonstrated that the docking technique provides the greatest resistance to valgus loading before mechanical failure. 29 Paletta et al 29 reported that the docking procedure (14.3 Nm) was nearly twice as strong as the Jobe technique (8.9 Nm) but was weaker than the native ligament (18.8 Nm).…”

“…Next, the split native UCL ligament was reapproximated by y References 1,2,5,9,18,21,23,24,28,29,31,33,36,38 …”

Study comparing the efficacy of platelet rich plasma versus steroid versus placebo in lateral epicondylitis

“…22 Hechtman et al concluded that a single injection of PRP gives significant relief in recalcitrant cases of lateral epicondylitis which is comparable to our study. 23 Gosens et al in his study, stated that the recurrence rate and need for repeated injection or surgery was also larger higher in the corticosteroid group than in the PRP group. 21 Andia et al studied thirteen prospective controlled studies, comprising of 886 patients which includes diverse tendons.…”

Avulsion Fracture of the Sublime Tubercle: A Case Report

“…Traumatic injuries to the ulnar collateral ligament of the elbow are reasonably common in people engaged in sporting activities [5][6][7][8]. However, a traumatic avulsion fracture of the sublime tubercle of the ulnar coronoid process is an underreported injury.…”

“…However, a traumatic avulsion fracture of the sublime tubercle of the ulnar coronoid process is an underreported injury. The ulnar collateral ligament is the elbow's primary soft tissue constraint to valgus instability [5,6,[8][9][10][11][12][13]. Inappropriate treatment of these injuries can lead to symptoms of elbow instability.…”