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This Article Full Text Full Text (PDF) All Versions of this Article: 34/12/1926    most recent 0363546506290988v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Request Reprints Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (9) Citing Articles via Google Scholar Google Scholar Articles by Dodson, C. C. Articles by Altchek, D. W. Search for Related Content PubMed PubMed Citation Articles by Dodson, C. C. Articles by Altchek, D. W. Related Collections Elbow Baseball Arthroscopy Operative

Medial Ulnar Collateral Ligament Reconstruction of the Elbow in Throwing Athletes

From Shoulder and Sports Medicine Service, Hospital for Special Surgery, New York, New York

^* Address correspondence to David W. Altchek, MD, Chief, Shoulder and Sports Medicine Service, Hospital for Special Surgery, New York, NY 10021 (e-mail: altchekd{at}hss.edu).

Background: Medial ulnar collateral ligament insufficiency of the elbow can be a devastating injury in the throwing athlete. Reconstruction of the medial ulnar collateral ligament was initially described by Jobe and associates; good clinical results have been described after this procedure. The authors’ experience with this technique raised several concerns, and thus the "docking" procedure was developed as an alternative method for medial ulnar collateral ligament reconstruction of the elbow. The early results of the docking technique were good. The authors wish to investigate the intermediate-term clinical results of this method in a large group of athletes.

Hypothesis: The docking technique can return overhead-throwing athletes to sport with minimal perioperative morbidity.

Study Design: Case series; Level of evidence, 4.

Methods: During a 3-year period, 100 consecutive overhead-throwing athletes were treated with surgical reconstruction using the docking technique. The inclusion criteria were as follows: (1) a history of medial elbow pain that prevented throwing, (2) a preoperative standard noncontrast magnetic resonance image demonstrating medial ulnar collateral ligament injury, (3) clinically apparent medial ulnar collateral ligament insufficiency, and (4) an overhead-throwing athlete. At the time of surgery, all patients underwent routine arthroscopic assessment. The ulnar nerve was transposed in 22 cases. The mean follow-up was 36 months (range, 24–60 months).

Results: Ninety of 100 (90%) patients were able to compete at the same or a higher level than before medial ulnar collateral ligament injury for more than 12 months as noted at the follow-up interval; 7 patients were able to compete at a lower level. Only 3 patients suffered postoperative complications.

Conclusion: The docking technique reliably returns athletes to competitive throwing with a low perioperative morbidity.

Key Words: docking technique • medial ulnar collateral ligament (MUCL) • valgus instability • Tommy John surgery

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