Medial Ulnar Collateral Ligament Reconstruction: A Dual Docking, 4-Ply Reconstructive Technique

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomechanics

Background:

• Ulnar collateral ligament (UCL) injuries are prevalent in overhead athletes.
• The anterior band of the UCL is crucial for stabilizing against valgus stress during throwing.
• Existing surgical techniques have shown good to excellent results, but modifications aim to enhance reconstruction strength and patient recovery.

Purpose of the Study:

• To describe a modified 4-ply ulnar collateral ligament reconstruction technique.
• To evaluate the potential for superior biomechanical properties and patient outcomes.
• To present a reproducible surgical method with potential advantages over existing procedures.

Main Methods:

• Utilized a gracilis autograft for medial ulnar collateral ligament reconstruction.
• Employed a cortical button tension loop construct for proximal to distal graft passage and fixation at the ulna.
• Incorporated a high-tensile strength suture tape in parallel during distal to proximal repassage to create a reinforced 4-ply construct.

Main Results:

• The described technique creates a reinforced, 4-ply UCL reconstruction with excellent tensile strength.
• This method avoids bony bridge fracture and preserves ulnar bone stock.
• Expected outcomes include >90% excellent patient results and >80% return to sport for overhead athletes.

Conclusions:

• The 4-ply UCL reconstruction with suture tape augmentation provides a rigid, high-tensile strength repair.
• This technique offers excellent outcomes and a high rate of return to play.
• It minimizes surgical complications associated with other UCL reconstruction methods.