Biomechanical Comparison of Ulnar Collateral Ligament Reconstruction With and Without Suture Augmentation.
UCL reconstruction
elbow
internal brace
overhead athletes
suture augmentation
Journal
The American journal of sports medicine
ISSN: 1552-3365
Titre abrégé: Am J Sports Med
Pays: United States
ID NLM: 7609541
Informations de publication
Date de publication:
07 2022
07 2022
Historique:
pubmed:
21
6
2022
medline:
19
7
2022
entrez:
20
6
2022
Statut:
ppublish
Résumé
A common concern associated with elbow ulnar collateral ligament (UCL) reconstruction is the amount of time required for recovery and rehabilitation. For example, for Major League Baseball pitchers, the average time to return to competition ranges from 13.8 to 20.5 months. Suture tape augmentation has shown the ability to provide additional soft tissue stability across other joints in the body. By providing an additional checkrein to the UCL reconstruction while the graft is healing, it may be possible to accelerate the rehabilitation process in overhead athletes and thus effect a quicker return to sports. To compare elbow valgus stability and load to failure between UCL reconstruction with and without suture tape augmentation. Controlled laboratory study. Fresh-frozen cadaveric elbows (N = 24) were dissected to expose the UCL. Medial elbow stability was tested with the UCL intact, deficient, and reconstructed utilizing the 3-strand docking technique with or without suture augmentation. A 3-N·m valgus torque was applied to the elbow, and valgus rotation of the ulna was recorded via motion-tracking cameras as the elbow was cycled through a full range of motion. After kinematic testing, reconstructed specimens were loaded to failure at 70° of elbow flexion. UCL-deficient elbows demonstrated significantly greater valgus rotation when compared with intact and internally braced reconstructed elbows at every angle of flexion tested and when compared with unbraced UCL-reconstructed elbows at 50° to 120° of flexion ( In this cadaveric model, 3-strand UCL reconstruction with suture augmentation did not overconstrain the elbow throughout all flexion angles when compared with the native state and UCL reconstruction alone, while providing greater load to failure. Suture tape augmentation may provide the additional strength necessary to accelerate rehabilitation after UCL reconstruction.
Sections du résumé
BACKGROUND
A common concern associated with elbow ulnar collateral ligament (UCL) reconstruction is the amount of time required for recovery and rehabilitation. For example, for Major League Baseball pitchers, the average time to return to competition ranges from 13.8 to 20.5 months. Suture tape augmentation has shown the ability to provide additional soft tissue stability across other joints in the body. By providing an additional checkrein to the UCL reconstruction while the graft is healing, it may be possible to accelerate the rehabilitation process in overhead athletes and thus effect a quicker return to sports.
PURPOSE
To compare elbow valgus stability and load to failure between UCL reconstruction with and without suture tape augmentation.
STUDY DESIGN
Controlled laboratory study.
METHODS
Fresh-frozen cadaveric elbows (N = 24) were dissected to expose the UCL. Medial elbow stability was tested with the UCL intact, deficient, and reconstructed utilizing the 3-strand docking technique with or without suture augmentation. A 3-N·m valgus torque was applied to the elbow, and valgus rotation of the ulna was recorded via motion-tracking cameras as the elbow was cycled through a full range of motion. After kinematic testing, reconstructed specimens were loaded to failure at 70° of elbow flexion.
RESULTS
UCL-deficient elbows demonstrated significantly greater valgus rotation when compared with intact and internally braced reconstructed elbows at every angle of flexion tested and when compared with unbraced UCL-reconstructed elbows at 50° to 120° of flexion (
CONCLUSION
In this cadaveric model, 3-strand UCL reconstruction with suture augmentation did not overconstrain the elbow throughout all flexion angles when compared with the native state and UCL reconstruction alone, while providing greater load to failure.
CLINICAL RELEVANCE
Suture tape augmentation may provide the additional strength necessary to accelerate rehabilitation after UCL reconstruction.
Identifiants
pubmed: 35722811
doi: 10.1177/03635465221101421
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM