Jackson Garrett R, Mowers Colton C, Sachdev Divesh, Knapik Derrick M, Lapica Hans, Sabesan Vani J
Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri, U.S.A.
Rush University Medical College, Chicago, Illinois, U.S.A.
Arthroscopy. 2025 Apr;41(4):1099-1112.e1. doi: 10.1016/j.arthro.2024.03.039. Epub 2024 Apr 8.
To systematically review the literature to provide an updated evaluation of postoperative clinical outcomes, return to play (RTP), and postoperative complications after primary ulnar collateral ligament reconstruction (UCLR) in throwing and nonthrowing athletes at minimum 2-year follow-up.
A literature search was performed on November 25, 2023, by querying the Embase, PubMed, and Scopus online databases using the 2020 Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. The inclusion criteria consisted of Level I to IV human clinical studies reporting postoperative outcomes and/or complications after primary UCLR with minimum 2-year follow-up. The exclusion criteria consisted of non-English-language studies; biomechanical, animal, and cadaveric studies; review articles; letters to the editor; and studies not reporting postoperative outcomes or complications. Study quality was evaluated using the Methodological Index for Non-Randomized Studies criteria. The incidence of reported complications among the included studies was extracted. Clinical outcome scores included the Kerlan-Jobe Orthopaedic Clinic Shoulder & Elbow (KJOC) score, Andrews-Timmerman (AT) score, and satisfaction score. RTP data were also extracted.
A total of 21 studies published from 2006 to 2023, consisting of 2,452 patients (2,420 male patients) with a mean age of 21.7 years (mean range, 12-65 years) and mean follow-up period of 50.5 months (mean range, 24-151.2 months), were included. The mean Methodological Index for Non-Randomized Studies score was 16 (range, 13-20). A total of 46% of patients (1,138 of 2,452) underwent concomitant ulnar nerve transposition. Palmaris graft was the most frequently used method (66.6%; n = 1,799), followed by hamstring graft (26.0%, n = 703). At the final follow-up, mean postoperative KJOC scores ranged from 72.0 to 88.0; mean AT scores, from 83.6 to 98.3; and mean satisfaction scores, from 86.1 to 98.3. The overall RTP rate ranged from 62.5% to 100% at a mean range of 9.5 to 18.5 months. The total incidence of complications ranged from 0% to 31.8%, with 0% to 7.4% of patients undergoing revision surgery.
UCLR was commonly performed using a palmaris graft, with concomitant ulnar nerve transposition reported in 46% of patients. At a mean follow-up of 50.5 months, mean postoperative KJOC scores ranged from 72 to 98.3, AT scores ranged from 83.6 to 98.3, and satisfaction scores ranged from 86.1 to 98.3, with variable RTP rates.
Level IV, systematic review of Level II to IV studies.
系统回顾文献，对投掷和非投掷运动员初次尺侧副韧带重建（UCLR）术后至少2年随访的临床结果、恢复运动（RTP）情况及术后并发症进行最新评估。
于2023年11月25日进行文献检索，使用2020年系统评价和Meta分析的首选报告项目指南查询Embase、PubMed和Scopus在线数据库。纳入标准包括I至IV级人类临床研究，报告初次UCLR术后至少2年随访的结果和/或并发症。排除标准包括非英语研究；生物力学、动物和尸体研究；综述文章；给编辑的信件；以及未报告术后结果或并发症的研究。使用非随机研究方法学指数标准评估研究质量。提取纳入研究中报告的并发症发生率。临床结果评分包括Kerlan-Jobe骨科诊所肩肘（KJOC）评分、安德鲁斯-蒂默曼（AT）评分和满意度评分。还提取了RTP数据。
共纳入2006年至2023年发表的21项研究，包括2452例患者（2420例男性患者），平均年龄21.7岁（平均范围12 - 65岁），平均随访期50.5个月（平均范围24 - 151.2个月）。非随机研究方法学指数的平均评分为16（范围13 - 20）。共有46%的患者（2452例中的1138例）接受了尺神经移位术。掌长肌腱移植是最常用的方法（66.6%；n = 1799），其次是腘绳肌腱移植（26.0%，n = 703）。在最后随访时，术后KJOC评分平均范围为72.0至88.0；AT评分平均范围为83.6至98.3；满意度评分平均范围为86.1至98.3。总体RTP率在9.5至18.5个月的平均范围内为62.5%至100%。并发症总发生率为0%至31.8%，0%至7.4%的患者接受了翻修手术。
UCLR通常采用掌长肌腱移植，46%的患者报告有尺神经移位术。平均随访50.5个月时，术后KJOC评分平均范围为72至98.3，AT评分平均范围为83.6至98.3，满意度评分平均范围为86.1至98.3，RTP率各不相同。
IV级，对II至IV级研究的系统评价。
