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Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, New York
Presented at the 26th annual meeting of the AOSSM, Sun Valley, Idaho, June 2000.
Address correspondence and reprint requests to David W. Altchek, MD, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021
Background: Medial collateral ligament insufficiency of the elbow with resultant valgus instability in throwing athletes is typically treated with free tendon graft reconstruction as described by Jobe.
Hypothesis: Improved results could be obtained with the use of the docking technique.
Study Design: Uncontrolled retrospective review.
Methods: The study group consisted of 36 athletes who had symptomatic insufficiency of the medial collateral ligament confirmed by magnetic resonance imaging and by surgical findings. Average follow-up was 3.3 years. Key elements of the docking technique included a muscle-splitting approach without routine transposition of the ulnar nerve, routine arthroscopic assessment, treatment of associated lesions, and docking the two ends of the tendon graft into a single humeral tunnel.
Results: Thirty-three of 36 patients (92%) returned to or exceeded their previous level of competition for at least 1 year, meeting the Conway-Jobe classification criteria of "excellent." All 22 professional or collegiate athletes returned to or exceeded their previous competition level.
Conclusions: The docking technique allowed simplified graft tensioning and improved graft fixation.
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