American Sports Medicine Institute, Birmingham, Alabama, USA.
MedStar Health, Baltimore, Maryland, USA.
Am J Sports Med. 2019 Apr;47(5):1096-1102. doi: 10.1177/0363546519833684.
There has been a renewed interest in ulnar collateral ligament (UCL) repair in overhead athletes because of a greater understanding of UCL injuries, an improvement in fixation technology, and the extensive rehabilitation time to return to play.
PURPOSE/HYPOTHESIS: To evaluate the clinical outcomes of a novel technique of UCL repair with internal brace augmentation in overhead throwers.
Case series; Level of evidence, 4.
Patients undergoing a novel technique of UCL repair with internal brace augmentation were prospectively followed for a minimum of 1 year. Potential candidates for repair were selected after the failure of nonoperative treatment when imaging suggested a complete or partial avulsion of the UCL from either the sublime tubercle or medial epicondyle, without evidence of poor tissue quality of the ligament. The final decision on UCL repair or traditional reconstruction was determined intraoperatively. Demographic and operative data were collected at the time of surgery. Return to play, and Kerlan-Jobe Orthopaedic Clinic (KJOC) scores were collected at 1 year and then again at 2 years postoperatively.
Of the 111 overhead athletes eligible for the study, 92% (102/111) of those who desired to return to the same or higher level of competition were able to do so at a mean time of 6.7 months. These patients had a mean KJOC score of 88.2 at final follow-up.
UCL repair with internal brace augmentation is a viable option for amateur overhead throwers with selected UCL injuries who wish to return to sport in a shorter time frame than allowed by traditional UCL reconstruction.
由于对 UCL 损伤有了更深入的了解、固定技术的改进以及恢复运动所需的广泛康复时间,人们对治疗过头投掷运动员的 UCL 侧副韧带(UCL)再次产生了兴趣。
目的/假设:评估过顶投掷运动员 UCL 修复的新型技术(内部支撑增强)的临床结果。
病例系列;证据等级,4 级。
对接受 UCL 修复新型技术(内部支撑增强)的患者进行前瞻性随访,随访时间至少为 1 年。当影像学显示 UCL 从 sublime 结节或内上髁完全或部分撕脱,且没有韧带组织质量差的证据时,选择经过非手术治疗失败且可能需要修复的患者。UCL 修复或传统重建的最终决定是在术中确定的。在手术时收集人口统计学和手术数据。在术后 1 年和 2 年时收集重返运动和 Kerlan-Jobe 骨科诊所(KJOC)评分。
在符合研究条件的 111 名过头运动员中,有 92%(102/111)希望恢复到相同或更高运动水平的患者能够在平均 6.7 个月时恢复运动。这些患者的最终 KJOC 评分为 88.2。
对于希望在比传统 UCL 重建允许的时间框架内更快地重返运动的有选择 UCL 损伤的业余过头投掷运动员来说,UCL 修复与内部支撑增强是一种可行的选择。