Biomechanical Comparison of Ulnar Collateral Ligament Reconstruction Between Palmaris Longus Autograft and Knee Medial Collateral Ligament Allograft.

Background

Medial ulnar collateral ligament (mUCL) injury can cause significant pain and alter throwing mechanics. Common autograft options for mUCL reconstruction (UCLR) include the palmaris longus (PL) and hamstring tendons. Allograft use may reduce donor site morbidity and decrease function related to PL autografts.

Purpose

To compare varus stability and load to failure between a novel allograft for UCLR-knee medial collateral ligament (kMCL)-and a PL autograft in human donor elbow specimens.

Study Design

Controlled laboratory study.

Methods

A total of 24 fresh-frozen human elbows were dissected to expose the mUCL. Medial elbow stability was tested with the mUCL intact (native), deficient, and reconstructed utilizing the humeral single-docking technique with either a (1) kMCL allograft (n = 12) or (2) a PL autograft (n = 12). A 3-N·m valgus torque was applied to the elbow, and valgus rotation of the ulna was recorded via motion tracking cameras. The elbow was cycled through a full range of motion 5 times. After kinematic testing, specimens were loaded to failure at 70° of elbow flexion, and failure modes were recorded.

Results

The mUCL-deficient elbows demonstrated significantly greater valgus rotation compared with the intact and reconstructed elbows at every flexion angle tested (10°-120°) (

Conclusion

Fresh-frozen and aseptically processed kMCL allografts demonstrated similar kinematic and failure properties to PL tendon autografts in UCL-reconstructed elbows, although neither graft fully restored kinematics between 10° and 40°.

Clinical Relevance

Prepared kMCL ligament allografts may provide a viable graft material when reconstructing elbow ligaments while avoiding the potential complications related to PL autografts- including donor site morbidity.

Informations de copyright

© The Author(s) 2024.

Déclaration de conflit d'intérêts

One or more of the authors has declared the following potential conflict of interest or source of funding: This work was supported by a 2021 Junior Investigator Grant from MTF Biologics (principal investigator, M.A.S.). M.A.S. has received research support from Integra; education payments from Arthrex; consulting fees from Encore Medical, Arthrex, and Johnson & Johnson; nonconsulting fees from Arthrex; honoraria from Encore Medical; and hospitality payments from Micromed, Integra LifeSciences, and Wright Medical. L.C. has received education payments from Micromed and hospitality payments from Arthrex and Medical Device Business Services. D.A.K. has received education payments from Micromed; consulting fees from MTF Biologics; honoraria from MTF Biologics; and hospitality payments from Sientra. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto. Ethical approval was not sought for the present study.