Torres Stephen J, Limpisvasti Orr
Cedars-Sinai, Kerlan-Jobe Institute, 6801 Park Terrace, Los Angeles, CA, 90045, USA.
Curr Rev Musculoskelet Med. 2021 Apr;14(2):168-173. doi: 10.1007/s12178-021-09698-4. Epub 2021 Feb 9.
Traditionally medial elbow injuries in overhead athletes have been treated with ulnar collateral ligament (UCL) reconstruction as first described by Dr. Frank Jobe. Recent literature has shown favorable outcomes in select patients treated with UCL repair. Newer techniques utilizing suture augmentation demonstrate biomechanical profiles as good or better than the native state and/or reconstruction. This review aims to evaluate these biomechanical studies and the clinical outcomes of ulnar collateral ligament repair with suture augmentation.
UCL repair has favorable outcomes in select patients with specific tear type patterns. Clinical outcomes have shown return to play rates of 92-97% with mean time of 2.5-6 months post-operatively. Biomechanical data comparing UCL repair to reconstruction techniques have shown improved resistance to common forces applied to the elbow during overhead activities. Additionally, suture tape augmentation dramatically improves stability of ligament repair without over-constraining the elbow. Initial ulnar collateral ligament repair data was poor, and thus UCL reconstruction became the mainstay of treatment for overhead athletes. Recent studies evaluating the biomechanical properties as well as clinical outcomes have demonstrated favorable data when UCL repair is performed. When considering the drawbacks of a prolonged recovery associated with reconstruction, UCL repair is a viable option in select patients.
传统上，对于过头运动运动员的内侧肘部损伤，一直采用由弗兰克·乔布医生首次描述的尺侧副韧带（UCL）重建术进行治疗。最近的文献表明，在接受UCL修复治疗的特定患者中取得了良好的效果。利用缝线增强的新技术显示出与天然状态和/或重建相当或更好的生物力学特性。本综述旨在评估这些生物力学研究以及缝线增强修复尺侧副韧带的临床结果。
UCL修复在特定撕裂类型模式的特定患者中具有良好的效果。临床结果显示，术后平均2.5至6个月的重返比赛率为92%至97%。将UCL修复与重建技术进行比较的生物力学数据表明，在过头活动期间，对施加于肘部的常见力量的抵抗力有所提高。此外，缝线带增强显著提高了韧带修复的稳定性，而不会过度限制肘部。最初的尺侧副韧带修复数据较差，因此UCL重建成为过头运动运动员治疗的主要方法。最近评估生物力学特性以及临床结果的研究表明，进行UCL修复时会得到良好的数据。考虑到与重建相关的恢复时间延长的缺点，UCL修复在特定患者中是一种可行的选择。
