Ulnar Collateral Ligament Reconstruction: Anatomy, Indications, Techniques, and Outcomes

Area of Science:

• Orthopedic surgery
• Sports medicine
• Biomechanics

Background:

• Ulnar collateral ligament (UCL) injuries cause pain and performance loss in throwing athletes.
• Ulnar collateral ligament reconstruction (UCLR) is a treatment for symptomatic UCL deficiency.
• UCL injuries result from chronic microtrauma or acute ruptures.

Purpose of the Study:

• To review the literature on ulnar collateral ligament reconstruction (UCLR) outcomes.
• To evaluate the effectiveness of UCLR for athletes experiencing elbow pain and performance decline.

Main Methods:

• Comprehensive literature search of databases, articles, and research institutions from 1970-2015.
• Inclusion of clinical reviews and studies reporting UCLR outcomes (Level 5 evidence).

Main Results:

• UCLR demonstrates excellent outcomes for recreational and elite athletes, facilitating return to sport.
• Various graft choices (palmaris longus, gracilis, semitendinosus, allograft) show comparable results.
• Potential complications include graft failure, ulnar nerve issues, stiffness, pain, and decreased performance.

Conclusions:

• Ulnar collateral ligament injuries are prevalent in pitchers; nonoperative treatment has limited success.
• UCLR techniques show promising results in retrospective studies, with careful planning and rehabilitation being key.
• Successful UCLR requires meticulous surgical technique and a thorough post-operative rehabilitation program to minimize complications like ulnar neuropathy and return-to-sport failure.