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LUCL internal bracing restores posterolateral rotatory stability of the elbow

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  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Posterolateral rotatory instability (PLRI) of the elbow occurs from an insufficient lateral collateral ligament complex (LCLC). For subacute LCLC injuries, lateral ulnar collateral ligament (LUCL) internal bracing rather than reconstruction may be a viable option. The purpose of the study was to compare the stabilizing effects of LUCL internal bracing to triceps tendon graft reconstruction in simulated PLRI.

Methods

Sixteen cadaveric elbows were assigned for either LUCL internal bracing (n = 8) or reconstruction with triceps tendon graft (n = 8). Specimen were mounted and a valgus rotational torque was applied to the ulna to test posterolateral rotatory stability. Posterolateral rotation was measured at 0°, 30°, 60°, 90° and 120° of elbow flexion. Cyclic loading was performed for 1000 cycles at 90° of elbow flexion. Three conditions were compared in each specimen: intact elbow, LUCL and radial collateral ligament (RCL) transected, and then either LUCL internal bracing or reconstruction with triceps tendon graft.

Results

Transection of the LUCL and RCL significantly increased posterolateral rotation in all degrees of elbow flexion compared to the intact condition (P < 0.05). Both LUCL internal bracing and reconstruction restored posterolateral rotatory stability to the native state between 0° and 120° of elbow flexion, with no significant difference in improvement between groups. Similarly, LUCL internal bracing and reconstruction groups showed no significant difference in posterolateral rotation compared to the intact condition during cyclic loading.

Conclusions

At time zero, both LUCL internal bracing and reconstruction with triceps tendon graft restored posterolateral rotatory stability. As such, this study supports the use of internal bracing as an adjunct to primary ligament repair in subacute PLRI.

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Funding

The University of Connecticut Health Center/UConn Musculoskeletal Institute has received direct funding and material support from Arthrex Inc., Naples, Fl. The company had no influence on study design, data collection, interpretation of the results or the final manuscript.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of Connecticut, Farmington, CT, USA

    Bastian Scheiderer, Florian B. Imhoff, Cameron Kia, James Aglio, Daichi Morikawa, Elifho Obopilwe, Mark P. Cote & Augustus D. Mazzocca

  2. Department of Orthopaedic Sports Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany

    Bastian Scheiderer, Florian B. Imhoff, Lucca Lacheta, Andreas B. Imhoff & Sebastian Siebenlist

  3. Department of Orthopaedic Surgery, Juntendo University, Tokyo, Japan

    Daichi Morikawa

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  1. Bastian Scheiderer
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Correspondence to Bastian Scheiderer.

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Conflict of interest

Authors Scheiderer B, Imhoff FB, Kia C, Aglio J, Morikawa D, Obopilwe E, Cote MP and Lacheta L declare that they have no conflict of interest and nothing to disclose. Author Imhoff AB is a consultant for Arthrosurface and mediBayreuth, and receives royalties from Arthrex Inc. and Arthrosurface. Author Mazzocca AD is a consultant for Arthrex Inc., Orthofix and receives research grants from Arthrex Inc.. Author Siebenlist S is a consultant for Arthrex Inc..

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Scheiderer, B., Imhoff, F.B., Kia, C. et al. LUCL internal bracing restores posterolateral rotatory stability of the elbow. Knee Surg Sports Traumatol Arthrosc 28, 1195–1201 (2020). https://doi.org/10.1007/s00167-019-05632-x

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  • DOI: https://doi.org/10.1007/s00167-019-05632-x

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