Abstract
Medial elbow pain is common in the overhead throwing athlete. The diagnosis of medial ulnar collateral ligament (MUCL injuries is mostly based on a history of medial elbow pain, physical exam findings, and imaging studies. The repeated valgus load that causes MUCL attenuation or rupture might also cause ulnar nerve symptoms, posterior impingement, formation of posteromedial osteophytes, formation of loose bodies, stress fractures of the ulna, lateral plica syndrome, trochlea chondromalacia, and less commonly capitellar osteochondritis dissecans (OCD) lesions. Operative treatment of MUCL insufficiency involves open graft reconstruction, but failure to address associated conditions may compromise outcomes of reconstruction. With direct visualization afforded by arthroscopy, the diagnosis and treatment of concomitant pathology may be accomplished at the time of MUCL reconstruction, making elbow arthroscopy a useful adjuvant in the evaluation and treatment of elbow pain in the overhead athlete. The objective of this chapter will be to review the indications and techniques of elbow arthroscopy in athletes with MUCL insufficiency.
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References
Timmerman LA, Andrews JR. Undersurface tear of the ulnar collateral ligament in baseball players. Am J Sports Med. 1994;22(1):33–36, 64.
Rohrbough JT, Altchek DW, Hman J, Williams RJ III and Botts, JD. Medial collateral ligament reconstruction of the elbow using the docking technique. Am J Sports Med. 2002;30:541–548.
Bowers AL, Dines JS, Dines DM, et al. Elbow medial ulnar collateral ligament reconstruction: clinical relevance and the docking technique. J Shoulder Elbow Surg. 2010;19:110–7, 10.
Cain EL, Andrews JR, Dugas JR, Wilk KE, McMichael C, Walter JC, Riley R, Arthur ST. Outcome of ulnar collateral ligament reconstruction of the elbow in 1281 athletes: results in 743 athletes with minimum 2-year follow-up. Am J Sports Med. 2010;38:2426–34, 73.
Timmerman LA, Andrews JR. Histology and arthroscopic anatomy of the ulnar collateral ligament of the elbow. Am J Sports Med. 1994;22(5):667–73, 63.
Timmerman LA, Schwartz ML, Andrews JR. Preoperative evaluation of the ulnar collateral ligament by magnetic resonance imaging and computed tomography arthrography. Am J Sports Med. 1994;22(1):26–32, 65.
Field LD, Altchek DW. Evaluation of the arthroscopic valgus instability test of the elbow. Am J Sports Med. 1996;24(2):177–81, 21.
Azar FM, Andrews JR, Wilk KE. Operative treatment of ulnar collateral ligament injuries in the elbow in athlete. Am J Sports Med. 2000;28:16–23, 74.
Antuna SA, O’Driscoll SW. Snapping plicae associated with radiocapitellar chondromalacia. Arthroscopy. 2001;17(5):491–5.
Akagi M, Nakamura T. Snapping elbow caused by the synovial in the radiohumeral joint. J Shoudler Elbow Surg. 1998;7(4):427–9.
Reddy AS, Kvitne RS, Yocum LA, Elattrache NS, Glousman RE, Jobe FW. Arthroscopy of the elbow: a long-term clinical review. Arthroscopy. 2000;16(6):588–94, 54.
Andrews JR, Timmerman LA. Outcome of elbow surgery in professional baseball players. Am J Sports Med. 1995;23:407–13.
Wilson FD, Andrews JR, Blackburn T, Mccluskey G. Valgus extension overload in the pitching elbow. Am J Sports Med. 1983;11(2):83–8.
Ahmad C, Park MC, Elattrache NS. Elbow medial ulnar collateral ligament insufficiency alters posteromedial olecranon contact. Am J Sports Med. 2004;32(7):1607–12, 90.
Morrey BF. Primary degenerative arthritis of the elbow: treatment by ulnohumeral arthroplasty. J Bone Joint Surg. 1992;74A:410–3.
Kamineni S, Elattrache N, Odriscoll S, Ahmad C, Hirohara H, Peale P, An K, Morrey BF. Medial collateral ligament strain with partial posteromedial olecranon resection: a biomechanical study. J Bone Joint Surg Am. 2004;86(11):2424–30, 91.
Conway J. Olecranon exostosis in throwers. Presentation at American orthopedic society of sports medicine annual meeting 2000.
Ogilvie-Harris DJ, Schemitsch E. Arthroscopy of the elbow for removal of loose bodies. Arthroscopy. 1993;9:5–8.
Ward WG, Belhobek GH, Anderson TE. Arthroscopic elbow finding: correlation with preoperative radiographic studies. Arthroscopy. 1992;8:498–502.
Abboud J, Ricchetti E, Tjoumakaris F, et al. Elbow arthroscopy basic setup and portal placement. J Am Acad Orthop Surg. 2006;14:312–8.
O’Driscoll S, Morrey BF. Arthroscopy of the elbow: diagnostic and therapuetic benefits and hazards. J Bone Joint Surg Am. 1992;74A:84–94.
Stothers K, Day B, Regan W. Arthroscopy of the elbow: anatomy, portal sites, and a description of the proximal lateral portal. Arthroscopy. 1995;11(4):449–57.
Poehling GG, Whipple TL, Sisco L, Goldman B. Elbow arthroscopy, a new technique. Arthroscopy. 1989;5:222–81.
Lindenfeld TN. Medial approach in elbow arthroscopy. Am J Sports Med. 1990;18:413–7.
Verhaar J, van-Mameren H, Brandsma A. Risks of neurovascular injury in elbow arthroscopy: starting anteriomedially or anteriolaterally? Arthroscopy. 1991;7:287–90.
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Bush, C., Conway, J. (2015). The Role of Arthroscopy in Athletes with Ulnar Collateral Ligament Injuries. In: Dines, J., Altchek, D. (eds) Elbow Ulnar Collateral Ligament Injury. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-7540-9_14
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