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Autologous triceps tendon graft for LUCL reconstruction of the elbow: clinical outcome after 7.5 years

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

The objective of this study was to assess mid- to long-term functional outcomes in patients treated for symptomatic posterolateral instability of the elbow (PLRI) using an autologous ipsilateral triceps tendon as graft.

Methods

A total of 196 patients were treated with autologous triceps tendon graft for symptomatic PLRI at single orthopedic institution from 2006 to 2013. The surgical treatment contained arthroscopic instability testing, reconstruction of the lateral ulnar collateral ligament (LUCL) and harvesting autologous ipsilateral triceps tendon as graft. The follow-up outcomes included range of motion (ROM), pain measured on a visual analogue scale (VAS), Mayo Elbow Performance Score (MEPS), Oxford Elbow Score (OES) and ultrasound to evaluate the integrity of the refixation of the common extensor.

Results

A total of 178 patients (female: 73; male: 105) were available for follow-up at a mean of 91 months (range 48–144). No patient reported pain at rest; VAS during activity was 1.8 (range 0–5). The ROM decreased slightly compared to preoperative measurements. Flexion decreased significantly from 135.4 to 131.1, though still within the functional arc of motion. All but 13 patients (8.5%) were clinically stable. However, only two patients received a revision of the LUCL reconstruction due to subjective instability. The mean MEPS in the final follow-up was 91.3 (range 73–100). The mean OES was 46.5 (range 39–48). Three patients reported a pain-free clicking of the elbow. No patient complained about donor site morbidity of the ipsilateral triceps tendon. Ultrasound evaluation showed integrity of the common extensors in all patients.

Conclusions

LUCL reconstruction using the ipsilateral triceps tendon as graft shows good to excellent mid- to long-term results in the treatment of symptomatic posterolateral elbow joint instability with a low re-instability and complication rate.

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Funding

No funding was received for conducting this study.

Author information

Authors and Affiliations

  1. St. Vinzenz Klinik Pfronten GmbH, Kirchweg 15, 87459, Pfronten, Germany

    Christian Schoch, Michael Dittrich & Michael Geyer

  2. Department of Orthopaedics, Emory University, Atlanta, GA, USA

    Jesse Seilern und Aspang

  3. Department for Orthopaedic Sports Medicine, Technical University Munich, Klinikum Rechts Der Isar, Munich, Germany

    Stephanie Geyer

Authors
  1. Christian Schoch
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  2. Michael Dittrich
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  3. Jesse Seilern und Aspang
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  4. Michael Geyer
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  5. Stephanie Geyer
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Contributions

CS and MD performed patient recruitment and data collection and have written the first draft. SG and CS performed data analysis and interpretation. CS performed the literature review and primary manuscript preparation. JS, MG and SG assisted with initial drafting of the manuscript, as well as editing and final draft preparation. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Christian Schoch.

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Conflict of interest

Christian Schoch receives speaker’s fee by Arthrex (Arthrex Inc., Naples, FL, USA). All other 28 authors declare that they have no potential conflict of interest.

Ethical approval

This study was approved by the Hospitals Ethics Committee SVP-2005–02.

Informed consent

Verbal and written informed consent was obtained from each patient prior to participation.

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Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

The study was performed at the Department for Orthopedic Surgery at St. Vinzenz Klinik Pfronten, Germany.

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Cite this article

Schoch, C., Dittrich, M., Seilern und Aspang, J. et al. Autologous triceps tendon graft for LUCL reconstruction of the elbow: clinical outcome after 7.5 years. Eur J Orthop Surg Traumatol 32, 1111–1118 (2022). https://doi.org/10.1007/s00590-021-03081-2

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  • DOI: https://doi.org/10.1007/s00590-021-03081-2

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