Current Concepts in the Surgical Management of Elbow Medial Ulnar Collateral Ligament Injuries

The elbow medial ulnar collateral ligament (UCL) serves as the primary soft tissue restraint to valgus stress and is therefore critical to the stabilization of the elbow in overhead-throwing athletes. Injuries to the UCL present with medial elbow pain and altered performance. Reconstruction of the UCL is the "gold standard" for surgical treatment; however, rehabilitation after reconstruction can take 12 to 18 months. Recent advances in technique have led to an increased interest in augmented UCL repair, which boasts a quicker return to sport at 6 months on average. Appropriate candidates for repair may include athletes with proximal or distal avulsions with otherwise adequate quality UCL tissue. Augmented repair is biomechanically equivalent to reconstruction and clinically demonstrates high rates of return to play (>90%). Recently, augmented reconstruction has emerged as a technique to merge the benefits of reconstruction with repair, although clinical outcomes have yet to be defined.