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Revision ulnar collateral ligament reconstruction using a suspension button fixation technique.

Gregory H Lee1, Orr Limpisvasti, Maxwell C Park

  • 1Atlanta Knee and Shoulder Clinic, Atlanta, GA, USA. gleenwuedu@hotmail.com

The American Journal of Sports Medicine
|December 24, 2009
PubMed
Summary

Revision ulnar collateral ligament reconstruction using a suspension button fixation technique effectively restored elbow function and fixation strength, even with bone loss. This method offers a viable option for primary or revision elbow reconstruction.

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Area of Science:

  • Orthopedic Surgery
  • Biomechanical Engineering
  • Sports Medicine

Background:

  • Revision ulnar collateral ligament reconstruction presents significant challenges.
  • Ulnar cortical bone loss complicates existing reconstruction techniques.

Purpose of the Study:

  • To biomechanically evaluate a novel suspension button fixation technique for ulnar collateral ligament reconstruction.
  • To assess the technique's efficacy in cases of ulnar cortical bone loss.

Main Methods:

  • A controlled laboratory study utilizing nine pairs of cadaveric elbows.
  • Simulated ulnar cortical bone loss followed by ulnar collateral ligament reconstruction with a suspension button and palmaris longus autograft.
  • Quantified elbow valgus angle and performed load-to-failure testing.

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Main Results:

  • Reconstruction successfully restored elbow kinematics, showing no significant difference compared to intact ligaments.
  • Load-to-failure tests revealed a mean ultimate torque of 10.3 ± 5.7 N·m for reconstructed elbows.
  • Fixation strength was comparable to historic controls despite simulated bone loss.

Conclusions:

  • The suspension button fixation technique reliably restores elbow kinematics in ulnar collateral ligament reconstruction.
  • This technique provides comparable fixation strength to primary reconstruction methods, even with ulnar cortical bone loss.
  • Consideration for primary or revision ulnar collateral ligament reconstruction in cases of ulnar bone loss is warranted.