Erickson Brandon J, Bach Bernard R, Verma Nikhil N, Bush-Joseph Charles A, Romeo Anthony A
Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois, USA.
Orthop J Sports Med. 2017 Jan 25;5(1):2325967116682211. doi: 10.1177/2325967116682211. eCollection 2017 Jan.
Ulnar collateral ligament (UCL) tears have become common, and UCL reconstruction (UCLR) is currently the preferred surgical treatment method for treating UCL tears.
PURPOSE/HYPOTHESIS: The purpose of this study was to review the literature surrounding UCL repair and determine the viability of new repair techniques for treatment of UCL tears. We hypothesized that UCL repair techniques will provide comparable results to UCLR for treatment of UCL tears.
Systematic review and meta-analysis; Level of evidence, 4.
A systematic review was registered with PROSPERO and performed with PRISMA guidelines using 3 publicly available free databases. Biomechanical and clinical outcome investigations reporting on UCL repair with levels of evidence 1 through 4 were eligible for inclusion. Descriptive statistics were calculated for each study and parameter/variable analyzed.
Of the 46 studies eligible, 4 studies (3 clinical and 1 biomechanical) were included. There were 92 patients (n = 92 elbows; 61 males [62.3%]; mean age, 21.9 ± 4.7 years) included in the clinical studies, with a mean follow-up of 49 ± 14.4 months. Eighty-six percent of repairs performed were on the dominant elbow, and 38% were in college athletes. Most UCL repairs (66.3%) were performed via suture anchors. After UCL repair, 87.0% of patients were able to return to sport. Overall, 94.9% of patients scored excellent/good on the Andrews-Carson score. Patients who were able to return to sport after UCL repair did so within 6 months after surgery. Biomechanically, when UCL repair was compared with the modified Jobe technique, the repair group showed significantly less gap formation than the reconstruction group.
In patients for whom repair is properly indicated, UCL repair provides similar return-to-sport rates and clinical outcomes with shorter return-to-sport timing after repair compared with UCL reconstruction. Future outcome studies evaluating UCL repair with internal bracing are necessary before recommending this technique.
尺侧副韧带（UCL）撕裂已变得常见，目前UCL重建术（UCLR）是治疗UCL撕裂的首选手术治疗方法。
目的/假设：本研究的目的是回顾有关UCL修复的文献，并确定治疗UCL撕裂的新修复技术的可行性。我们假设UCL修复技术在治疗UCL撕裂方面将提供与UCLR相当的结果。
系统评价和荟萃分析；证据级别，4级。
在PROSPERO上注册了一项系统评价，并按照PRISMA指南使用3个公开可用的免费数据库进行。报告UCL修复且证据级别为1至4级的生物力学和临床结果研究符合纳入标准。对每项研究以及分析的参数/变量计算描述性统计量。
在符合条件的46项研究中，纳入了4项研究（3项临床研究和1项生物力学研究）。临床研究纳入了92例患者（n = 92个肘部；61例男性[62.3%]；平均年龄，21.9±4.7岁），平均随访49±14.4个月。所进行的修复中有86%是在优势侧肘部，38%是在大学运动员中。大多数UCL修复（66.3%）通过缝线锚钉进行。UCL修复后，87.0%的患者能够恢复运动。总体而言，94.9%的患者在安德鲁斯-卡森评分中获得优秀/良好。UCL修复后能够恢复运动的患者在术后6个月内恢复运动。在生物力学方面，将UCL修复与改良乔布技术进行比较时，修复组的间隙形成明显少于重建组。
对于合适的修复适应证患者，与UCL重建相比，UCL修复能提供相似的恢复运动率和临床结果，且修复后恢复运动的时间更短。在推荐这种技术之前，有必要进行未来的结果研究来评估使用内部支撑的UCL修复。
