Abstract
Background:
Incompetence of the ulnar collateral ligament (UCL) of the elbow is career-threatening for high-performance throwing athletes. Although multiple reconstructions have been described, a procedure that combines a larger graft with improved fixation may demonstrate more favorable loading characteristics than current techniques.
Hypothesis:
Ulnar collateral ligament reconstructions utilizing a semitendinosus graft and interference knot fixation will be biomechanically superior to previously reported techniques.
Study Design:
Controlled laboratory study.
Methods:
Thirty cadaveric elbows were stripped of all medial soft tissue superficial to the UCL. The proximal humeri were mounted on a materials testing system with the elbows flexed 90°. The intact UCL was loaded to failure at 4.5 deg/s. The torsional failure moment, torsional stiffness, and mode of failure were recorded. Three groups of 10 specimens were created. Group 1 underwent reconstruction using a palmaris tendon graft secured with interference knot fixation. Group 2 reconstructions utilized a palmaris graft and the docking technique. Group 3 specimens were reconstructed using a semitendinosus graft and interference knot fixation. All specimens were loaded to failure and the same parameters recorded.
Results:
The torsional failure moments for group 1 (13.28 Nm) and group 2 (12.81 Nm) reconstructions were significantly (
Conclusion:
Ulnar collateral ligament reconstruction utilizing semitendinosus graft and interference knot fixation restores the torsional strength of the intact UCL.
Clinical Relevance:
Reconstructions using semitendinosus grafts may allow for accelerated rehabilitation and earlier return to competition.
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