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Updated: Jul 5, 2025

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Ulnar Collateral Ligament Repair With Suture Tape Augmentation: Can You Overtighten?

Amir A Shahien1, David P Beason1, Jonathan S Slowik1

  • 1American Sports Medicine Institute, Birmingham, Alabama, USA.

The American Journal of Sports Medicine
|January 22, 2024
PubMed
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Ulnar collateral ligament (UCL) repair using maximal tensioning did not overconstraint the elbow joint compared to native biomechanics. Suture tape pull-through may mitigate initial tensioning effects over time.

Area of Science:

  • Orthopedic surgery
  • Sports medicine
  • Biomechanics

Background:

  • Growing interest in ulnar collateral ligament (UCL) repair for throwing athletes due to advancements in repair technology.
  • Improved outcomes data support wider implementation of UCL repair techniques.

Purpose of the Study:

  • Compare biomechanical parameters and failure modes of two brace-tightening techniques for UCL repair.
  • Evaluate the effects of physiologic versus maximal tensioning in UCL repair.

Main Methods:

  • Cadaveric arm specimens underwent UCL repair with suture tape augmentation.
  • Two tensioning techniques were applied: physiologic restoration and maximal tension.
  • Specimens were tested for valgus torque, articular contact, gap distance, angular displacement, and failure biomechanics.
Keywords:
augmentationbiomechanicalinternal bracerepairsuture tapeulnar collateral ligament

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Main Results:

  • Maximal tensioning significantly affected joint contact area, decreased gap distance, and reduced angular displacement.
  • Failure torque and stiffness were comparable between groups.
  • Significant differences were observed in suture tape pull-through length between the two tensioning methods.

Conclusions:

  • Maximal tension UCL repair may cause initial biomechanical changes but these can be mitigated by suture tape pull-through.
  • Neither repair technique resulted in elbow joint overconstraint compared to native biomechanics.
  • Further research on long-term outcomes will refine surgical recommendations for UCL repair.