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The Role of Biologics in Ulnar Collateral Ligament Injuries

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Elbow Ulnar Collateral Ligament Injury

Abstract

In the overhead athlete, medial ulnar collateral ligament (MUCL) insufficiency can develop from repetitive valgus loads across the elbow during the throwing motion. This injury can be potentially career ending for the athlete. Treatment options include conservative care or potential surgical intervention with ligament reconstruction. Given the prolonged recovery period after surgical intervention, other avenues for successful treatment of MUCL insufficiency have been explored, including potential injections into the ligament such as platelet-rich plasma (PRP) and autologous stem cells. Recently, PRP has drawn interest as a tool for biologic augmentation of tendon and ligamentous healing as it is an autologous concentration of platelets and growth factors including vascular endothelial growth factor, insulin-like growth factor-1, fibroblast growth factor-2, platelet-derived growth factor, and transforming growth factor-ß. Despite some evidence that supports the use of PRP injections for partial MUCL tears, there is no current consensus regarding its use. Research into the use of stem cell therapy remains primitive and while initial animal studies appear promising, their true clinical utility is unclear. Although the current literature is limited regarding the true efficacy of these treatment options, continued interest into the field of biologic augmentation still exists due to the potential for tissue regeneration. More specifically, biologic agents are especially appealing in the young overhead athlete with acute damage to an isolated part of the MUCL and in those athletes who are unwilling or unable to undergo the extended rehabilitation required after surgical reconstruction of the ligament.

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The authors did not receive any outside funding or grants in support of the research for or preparation of this work.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Sports Medicine and Shoulder Service, Sports Medicine Institute, Hospital for Special Surgery, New York, NY, USA

    John M. Apostolakos, Joshua Wright-Chisem, Joshua S. Dines & David W. Altchek

  2. Sports Medicine Institute, Hospital for Special Surgery, West Palm Beach, FL, USA

    James B. Carr II

  3. Mercy Health System, Janesville, WI, USA

    Michael E. Angeline

  4. New York Mets Baseball Club, Flushing, NY, USA

    John M. Zajac

  5. Orthopaedics and Sports Medicine, University of Washington Medical Center, Seattle, WA, USA

    Albert O. Gee

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  1. John M. Apostolakos
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  1. Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA

    Joshua S. Dines

  2. Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA

    Christopher L. Camp

  3. Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA

    David W. Altchek

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Apostolakos, J.M. et al. (2021). The Role of Biologics in Ulnar Collateral Ligament Injuries. In: Dines, J.S., Camp, C.L., Altchek, D.W. (eds) Elbow Ulnar Collateral Ligament Injury. Springer, Cham. https://doi.org/10.1007/978-3-030-69567-5_14

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  • Print ISBN: 978-3-030-69566-8

  • Online ISBN: 978-3-030-69567-5

  • eBook Packages: MedicineMedicine (R0)

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