Surgical Technique: Medial Ulnar Collateral Ligament Reconstruction Using Hamstring Allograft

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Reconstructive Surgery

Background:

• Medial ulnar collateral ligament (MUCL) injuries are common in overhead throwing athletes.
• Traditional autograft reconstruction has associated donor site morbidity.
• Hamstring allografts offer a promising alternative for MUCL reconstruction.

Purpose of the Study:

• To evaluate the efficacy of hamstring allografts for medial ulnar collateral ligament reconstruction.
• To compare outcomes of allograft vs. autograft reconstruction.
• To detail the surgical technique for hamstring allograft MUCL reconstruction.

Main Methods:

• Preoperative imaging (MRI/MRA) for tear assessment.
• Flexor-pronator split approach for medial elbow dissection.
• Hamstring allograft preparation with Krackow stitches.
• Single or double-hole ulnar-sided fixation techniques.
• Humeral-sided reconstruction with graft passage through bone tunnels.
• Graft tensioning and fixation with suture repair of the native ligament.

Main Results:

• Hamstring allograft reconstruction has yielded excellent results in MUCL repair.
• This technique provides an alternative to autografts, mitigating donor site complications.
• The described surgical steps ensure secure graft fixation and ligament repair.

Conclusions:

• Hamstring allograft is a safe and effective option for medial ulnar collateral ligament reconstruction.
• It achieves results comparable to autografts without the drawbacks of autograft harvest.
• This approach is suitable for overhead athletes requiring MUCL repair.