Universität zu Köln

Dargel, Jens, Kuepper, Fabian, Wegmann, Kilian, Oppermann, Johannes, Eysel, Peer and Mueller, Lars Peter (2015). Graft diameter does not influence primary stability of ulnar collateral ligament reconstruction of the elbow. J. Orthop. Sci., 20 (2). S. 307 - 314. AMSTERDAM: ELSEVIER. ISSN 1436-2023

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Abstract

Ulnar collateral ligament insufficiency may result in medial elbow pain, instability, and reduced athletic performance in throwing athletes. Several reconstruction methods have been described, but biomechanical studies suggest that in general, stability of the graft construct is inferior to the native ulnar collateral ligament. This study investigates whether a stronger graft would yield greater resistance to valgus load over the range of motion. Ten cadaveric elbows were mounted to a testing fixture and incremental valgus moments of 2.5, 5, and 7.5 Nm were applied with the elbow in 120A degrees, 90A degrees, 60A degrees, 30A degrees and 0A degrees of flexion and in varying rotational forearm positions. The intact and the ulnar collateral ligament released elbow joint were compared with the docking ulnar collateral ligament reconstruction technique, using different graft sources with increasing cross-sectional areas: palmaris longus, tricpes brachii, extensor carpi radialis longus, and semitendinosus. The resulting angular displacement was evaluated and compared between graft sources and different elbow positions. Compared with the intact situation, ulnar collateral ligament release resulted in a significant increase in valgus deformation over the entire range of flexion-extension motion. Ligament reconstruction using any graft source significantly restored valgus stability at 60A degrees, 90A degrees, and 120A degrees, while at 0A degrees and 30A degrees, angular valgus deformation did not significantly differ from the ulnar collateral ligament deficient situation. There were no significant differences in angular valgus deformation between the graft sources over the range of flexion motion or forearm rotation. This study did not prove that a thicker graft yielded more resistance to valgus moments when using the docking technique. Thicker grafts require larger bone tunnels, cannot be adequately tensioned, and are non-anatomic. Therefore, the palmaris longus or a triceps tendon strip are considered more appropriate for ulnar collateral ligament reconstruction.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Dargel, Jens UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuepper, Fabian UNSPECIFIED UNSPECIFIED UNSPECIFIED Wegmann, Kilian UNSPECIFIED UNSPECIFIED UNSPECIFIED Oppermann, Johannes UNSPECIFIED UNSPECIFIED UNSPECIFIED Eysel, Peer UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueller, Lars Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-405859
DOI:	10.1007/s00776-014-0688-y
Journal or Publication Title:	J. Orthop. Sci.
Volume:	20
Number:	2
Page Range:	S. 307 - 314
Date:	2015
Publisher:	ELSEVIER
Place of Publication:	AMSTERDAM
ISSN:	1436-2023
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language BIOMECHANICAL EVALUATION; REPAIR; JOINT Multiple languages Orthopedics Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/40585