Biomechanical Comparison of UCL Repair Using Suspensory Fixation Versus UCL Reconstruction

Area of Science:

• Orthopedic surgery
• Sports medicine
• Biomechanics

Background:

• Medial ulnar collateral ligament (mUCL) repair is increasingly used for younger athletes with mUCL tears.
• Traditional mUCL repair often uses screw fixation for proximal humeral stability.
• This study introduces an alternative suspensory fixation technique for proximal humeral fixation.

Purpose of the Study:

• To biomechanically compare elbow valgus stability and load to failure between a novel suspensory fixation mUCL repair and standard mUCL reconstruction.
• Evaluate the efficacy of alternative fixation methods in restoring elbow stability.

Main Methods:

• A controlled laboratory study using 18 fresh-frozen cadaveric elbows.
• Tested mUCL in intact, repaired (suspensory fixation with suture augmentation), and reconstructed states.
• Applied 3-N·m valgus torque to assess stability via motion tracking; loaded to failure at 70° flexion.

Main Results:

• Both mUCL repair and reconstruction restored valgus stability to levels comparable to intact ligaments across all flexion angles.
• No statistically significant difference was found in the ultimate torque to failure between the repaired and reconstructed mUCL groups.

Conclusions:

• Medial ulnar collateral ligament repair using suspensory fixation demonstrates equivalent valgus strength compared to mUCL reconstruction.
• Suspensory fixation serves as a viable alternative for proximal mUCL fixation without compromising construct strength.