State of the Union on Ulnar Collateral Ligament Reconstruction in 2020: Indications, Techniques, and Outcomes

Abstract

Purpose of Review There has been a marked increase in the number of ulnar collateral ligament reconstructions performed annually and an associated increase in the amount of recent literature published. It is paramount that surgeons remain up to date on the current literature, as modern indications and surgical techniques continue to improve clinical outcomes. Recent Findings Our understanding of ulnar collateral ligament (UCL) injuries, treatment indications, and surgical techniques for UCL reconstruction continues to evolve. Despite the rapidly increasing amount of published literature on the topic, a clear and concise surgical algorithm is lacking. Studies have suggested a trend towards improved clinical outcomes and decreased complications with various modifications in UCL reconstruction techniques. Current sport-specific outcome studies have reported conflicting results regarding the effect of UCL reconstruction on an athlete's performance upon returning to sport. Summary With the rising incidence of UCL reconstruction and growing media attention, UCL injuries, reconstruction techniques, and return to sport following UCL surgery are timely topics of interest to clinicians and overhead throwing athletes. Several technique modifications have been reported, and these modifications may lead to improved outcomes and lower complication rates. Studies assessing sport-specific outcome measures will be necessary to provide a more critical and informative analysis of outcomes following UCL reconstruction. Keywords Ulnar collateral ligament . UCL . Ulnar collateral ligament reconstruction . Return to sport . Overhead throwing athlete . Baseball This article is part of the Topical Collection on Injuries in Overhead Athletes

Biologics in shoulder and elbow pathology

“…Three such case series have been discussed at length in other review articles. 2 , 18 , 31 , 36 In short, Podesta et al found that among 34 athletes with symptomatic partial-thickness UCL tears, 88% treated with one PRP injection and a graded rehabilitation program returned to competition at an average time of 12 weeks. The study also reported significantly improved ultrasonographic medial joint space measurements and subjective questionnaire scores at follow-up.…”

Tommy John: Elbow Ulnar Collateral Ligament Allograft Reconstruction With Internal Brace

“…Ulnar collateral ligament (UCL) injuries of the elbow are most often a result of intense valgus forces placed on the elbow and frequently occur in young overhead athletes. 1 , 2 Injury occurs during late cocking and acceleration phases of throwing in such athletes as baseball pitchers. 1 The first reconstruction technique, performed by Dr. Frank Jobe, was made famous by notable Major League Baseball player Tommy John, who underwent the original “Tommy John” procedure to reconstruct his UCL in 1974.…”

“… 1 , 2 Injury occurs during late cocking and acceleration phases of throwing in such athletes as baseball pitchers. 1 The first reconstruction technique, performed by Dr. Frank Jobe, was made famous by notable Major League Baseball player Tommy John, who underwent the original “Tommy John” procedure to reconstruct his UCL in 1974. The UCL reconstruction allowed for a more successful career after surgery.…”