Rehabilitation of the medial- and lateral collateral ligament-deficient elbow: an in vitro biomechanical study.

DESIGN

In vitro biomechanical research using an elbow motion simulator.

INTRODUCTION

The optimal rehabilitation of elbow dislocations with medial collateral ligament (MCL) and lateral collateral ligament (LCL) injuries has not been defined.

PURPOSE

To determine a safe rehabilitation protocol for elbow dislocations with MCL and LCL injuries.

METHODS

Eight cadaveric elbows underwent simulated active and passive motions with the arm in multiple orientations. Varus-valgus angulation and internal-external rotation of the ulna relative to the humerus were quantified for the intact joint and with injured MCL and LCL.

RESULTS

Active motion with injured MCL and LCL in the horizontal and vertical orientations resulted in kinematics similar to the intact elbow, whereas passive motion resulted in significant kinematic alterations. Marked elbow instability was noted in the varus and valgus orientations using both active and passive motion.

CONCLUSIONS

Elbows with MCL and LCL injuries should be rehabilitated using active motion in the horizontal or vertical orientations.

LEVEL OF EVIDENCE

Basic science research.