Related Experiment Videos
Biomechanical evaluation of a new ulnar collateral ligament reconstruction technique with interference screw fixation
Christopher S Ahmad1, Thay Q Lee, Neal S ElAttrache
1Center for Shoulder, Elbow, and Sports Medicine, New York Orthopaedic Hospital, College of Physicians and Surgeons of Columbia University, New York, New York 10032, USA.
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 x 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.