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First published on August 16, 2004, doi:10.1177/0363546503263149
This version was published on October 1, 2004
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The American Journal of Sports Medicine 32:1607-1612 (2004)
© 2004 American Orthopaedic Society for Sports Medicine

Elbow Medial Ulnar Collateral Ligament Insufficiency Alters Posteromedial Olecranon Contact

Christopher S. Ahmad, MD*,{dagger}, Maxwell C. Park, MD{dagger} and Neal S. ElAttrache, MD{ddagger}

From the {dagger} Center for Shoulder, Elbow, and Sports Medicine, Department of Orthopaedic Surgery, Columbia University, New York, New York, and the {ddagger} Kerlan-Jobe Orthopaedic Clinic, Los Angeles, California

* Address correspondence to Christopher S. Ahmad, MD, Columbia University, Department of Orthopaedic Surgery, 622 West 168 Street, PH11-Center, New York, NY 10032 (e-mail: csa4{at}columbia.edu).

Background: The effect of elbow medial ulnar collateral ligament injury on posteromedial compartment contact is unknown.

Hypothesis: Medial ulnar collateral ligament injury causes altered contact area and pressure in the posteromedial compartment of the elbow.

Study Design: Controlled laboratory study.

Methods: Seven elbow cadaveric specimens were tested in an apparatus that positioned the elbow at 30° and 90° of flexion. Partial and full tears were simulated by releasing the medial ulnar collateral ligament. Pressure-sensitive film was placed in the posteromedial compartment for each condition. Valgus torques of 1.25 and 2.0 N·m were applied for each ligament condition, and kinematic data were obtained at each flexion angle using a 3-dimensional digitizer.

Results: Both ligament condition and valgus load had significant effects on contact area and pressure (P<.05). For a given load and flexion angle, the contact area decreased and the pressure increased with increasing medial ulnar collateral ligament insufficiency. Within these trends, statistical significance was found at 30° of elbow flexion for both area and pressure (P<.05); at 90° of elbow flexion, increasing medial ulnar collateral ligament insufficiency did not significantly affect contact area or pressure (P>.05).

Discussion: Medial ulnar collateral ligament insufficiency alters contact area and pressure between the posteromedial trochlea and olecranon and helps explain the development of posteromedial osteophytes.

Key Words: elbow • collateral ligament • biomechanics




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