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Related Concept Videos

Bones of the Upper Limb: Ulna01:15

Bones of the Upper Limb: Ulna

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The ulna and radius are parallel bones of the antebrachium or the forearm. The ulna lies medially and consists of a bony tip called the olecranon process at its proximal end. This hook-like projection articulates with the olecranon fossa of the humerus and forms the "hinged" ulnohumeral part of the elbow joint. This joint facilitates forearm extension and flexion while preventing its hyperextension. Similarly, the coronoid process, another bony projection on the proximal/anterior side...
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Tips for Successful Ulnar Collateral Ligament Reconstruction.

Amar S Vadhera1, Mariano E Menendez1,2, Zeeshan Khan1

  • 1Division of Sports Medicine, Department of Orthopedic Surgery, Rush University, Chicago, Illinois.

JBJS Essential Surgical Techniques
|November 20, 2025
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Summary
This summary is machine-generated.

Ulnar collateral ligament (UCL) reconstruction using hamstring autografts effectively restores elbow stability and function in overhead athletes. This procedure enables a high percentage of athletes to return to their previous level of play with favorable outcomes.

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Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Reconstructive Surgery

Background:

  • Ulnar collateral ligament (UCL) injuries are common in overhead-throwing athletes due to overuse and valgus stress.
  • UCL deficiency leads to decreased performance, pain, and instability, necessitating reconstructive procedures.
  • Ulnar collateral ligament reconstruction (UCLR) prevalence is increasing, especially in young baseball players.

Purpose of the Study:

  • To describe the surgical technique for ulnar collateral ligament reconstruction using a hamstring autograft.
  • To highlight key steps and considerations for a successful UCLR procedure.
  • To present the expected outcomes and high rate of return to sport following UCLR.

Main Methods:

  • Hamstring autograft harvest and preparation.
  • Anatomic centering of the reconstruction on the medial epicondyle.
  • Creation of tunnels in the sublime tubercle and medial epicondyle for graft passage and fixation.
  • Ulnar nerve management and graft tensioning.

Main Results:

  • Successful UCL reconstruction leads to high rates of return to play (94% in one study).
  • Favorable patient-reported outcomes, including high Kerlan-Jobe Orthopaedic Clinic (KJOC) and Andrews-Timmerman scores.
  • Low rates of revision surgery are associated with successful UCL reconstruction.

Conclusions:

  • Ulnar collateral ligament reconstruction with hamstring autograft is a reliable procedure for overhead athletes seeking to return to high-level throwing.
  • Meticulous surgical technique, including nerve preservation and proper graft fixation, is crucial for optimal outcomes.
  • This reconstructive approach effectively addresses symptoms and restores throwing capabilities in athletes with UCL deficiency.