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 bio-mechanically 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 N·m) and group 2 (12.81 N·m) reconstructions were significantly (P <.05) inferior to that of their respective native values (21.3 N·m and 23.5 N·m). Semitendinosus reconstructions (20.5 N·m) were not significantly different (P =.24) from their native UCLs (23.0 N·m). All reconstructions were torsionally less stiff (P <.001) than the native UCL. There were no statistically significant differences in stiffness between the groups (P =.4). 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.
- Elbow instability
- Interference knot
- Ulnar collateral ligament reconstruction
ASJC Scopus subject areas
- Orthopedics and Sports Medicine
- Physical Therapy, Sports Therapy and Rehabilitation