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Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 27, Issue 10, pp 3284–3290 | Cite as

Dual reconstruction of lateral collateral ligament is safe and effective in treating posterolateral rotatory instability of the elbow

  • Hyoung Seok Jung
  • Jae Sung Lee
  • In Hyeok Rhyou
  • Ho Won Lee
  • Min Jong ParkEmail author
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  • 173 Downloads

Abstract

Purpose

Although reconstruction of the lateral ulnar collateral ligament (LUCL) has been considered the procedure of choice for posterolateral rotatory instability (PLRI), recent studies have reported that the entire lateral collateral ligament complex (LCLC), rather than its posterior part only, contributes to preventing PLRI. Thus, it was hypothesized that dual reconstruction of the radial collateral ligament (RCL) and LUCL for the treatment of elbow PLRI could provide favourable clinical results regardless of the mechanism of injury.

Methods

This retrospective study reviewed the clinical results of 21 patients who underwent dual reconstruction of the RCL and LUCL between 2011 and 2016. Functional outcomes were assessed using the numeric rating scale (NRS) score, Mayo Elbow Performance Score (MEPS), quick Disabilities of the Arm, Shoulder, and Hand (quick DASH) score, and manual varus instability. To identify any difference in outcomes according to the aetiologies for LCLC insufficiency, our patients were divided into LCLC insufficiency associated with elbow dislocation and that with lateral epicondylitis.

Results

At a median follow-up of 27 months (range 13–65 months), all patients showed resolved instability and achieved a functional arc of motion. In addition, lateral pivot shift tests were negative in all patients. The median MEPS significantly improved after surgery from 70 (range 60–75) to 85 (range 75–100) (p < 0.001), while the median quick DASH score improved from 38.6 (range 26.6–54.5) to 11.4 (range 0–34.1) (p < 0.001). Clinical outcomes according to the aetiology of LCLC insufficiency were not significantly different except for the NRS score.

Conclusion

The results suggest that the dual reconstruction technique leads to a clinical outcome similar to that of conventional LUCL reconstruction in LCLC insufficiency regardless of aetiology. In addition, the dual reconstruction technique was technically easier than the conventional LUCL reconstruction technique and may be a potential alternative when a bone tunnel created at the proximal ulna by the original technique has failed.

Level of evidence

IV.

Keywords

Lateral ulnar collateral ligament Dual reconstruction Lateral epicondylitis Clinical outcomes Radial collateral ligament 

Notes

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Compliance with ethical standards

Conflict of interest

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Ethical approval

This study was approved by the Institutional Review Board of Samsung Medical Centre (no. 2018-02-154-001).

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2019

Authors and Affiliations

  1. 1.Department of Orthopaedic SurgeryMedical Centre of Chung-Ang University School of MedicineSeoulSouth Korea
  2. 2.Department of Orthopaedic Surgery, Upper Extremity and Microsurgery CentrePohang SM Christianity HospitalPohangSouth Korea
  3. 3.Department of Orthopaedic SurgeryKangnam Sacred Heart Hospital, Hallym University School of MedicineSeoulSouth Korea
  4. 4.Department of Orthopaedic Surgery, Samsung Medical CentreSungKyunKwan University School of MedicineSeoulSouth Korea

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