Abstract
Background: Techniques for ulnar collateral ligament reconstruction have evolved.
Hypothesis: Ulnar collateral ligament reconstruction with interference screw fixation restores elbow kinematics and failure strength to that of the native ligament.
Study Design: Controlled laboratory study.
Methods: Of 10 matched pairs of cadaveric elbows, one underwent kinematic testing under conditions of an intact, released, and reconstructed ligament. Single 5-mm diameter bone tunnels were created at the isometric anatomic insertion sites on the medial epicondyle and sublime tubercle. Graft fixation was achieved with 5 × 15 mm soft tissue interference screws. The reconstructed and contralateral intact elbows were then tested to failure.
Results: Average stiffness for intact elbows (42.81 ± 11.6 N/mm) was significantly greater than for reconstructed elbows (20.28 ± 12.5 N/mm). Ultimate moment for intact elbows (34.0 ± 6.9 N·m) was not significantly different from reconstructed elbows (30.6 ± 19.2 N·m). Release of the ulnar collateral ligament caused a significant increase in valgus instability. Reconstruction restored valgus stability to near that of the intact elbow.
Conclusions: With this reconstruction method, failure strength was comparable with that of the native ligament and physiologic elbow kinematics were reliably restored.
Clinical Relevance: This technique returns elbow kinematics to near normal, with less soft tissue dissection and risk of ulnar nerve injury and ease of graft insertion, tensioning, and fixation.
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