Koukos Christos, Schoeps Dominique, Windolf Joachim, Jeon In-Ho, Zolog Cristina, Ditsios Konstantinos, Latz David
Sports Trauma and Pain Institute, Thessaloniki, Greece.
Department of Trauma Surgery and Orthopaedics, University Hospital Düsseldorf, Düsseldorf, Germany.
Arthrosc Tech. 2025 Apr 2;14(6):103529. doi: 10.1016/j.eats.2025.103529. eCollection 2025 Jun.
Posterolateral rotatory instability (PLRI) is a chronic condition resulting from damage to the lateral ulnar collateral ligament (LUCL) and related structures causing painful restrictions and instability in elbow movement. Conservative treatment often falls short, necessitating surgical intervention to restore elbow stability. Traditionally, open LUCL reconstruction with tendon grafting has been the standard of care but involves substantial tissue disruption and extended recovery. Arthroscopic approaches offer a less-invasive alternative with reduced soft-tissue damage and faster recovery. This Technical Note presents an algorithm-driven, arthroscopically assisted technique for PLRI treatment. Using magnetic resonance imaging to evaluate the common extensor origin's integrity, surgical options include LUCL plication with anchor fixation and lateral collateral ligament imbrication. During surgery, a minimally invasive technique is employed leveraging arthroscopy for precise ligament inspection and anchor-based fixation. Sutures stabilize the LUCL and lateral collateral ligament, addressing instability while preserving tissue integrity. This approach enables rapid postoperative rehabilitation and reduces the risk of motion restrictions. Although suitable for grade 1 and 2 PLRI, the technique demands high arthroscopic proficiency. This minimally invasive method allows effective management of elbow instability while promoting quicker patient recovery and long-term functional restoration.
后外侧旋转不稳定（PLRI）是一种慢性疾病，由尺侧副韧带（LUCL）及相关结构损伤引起，导致肘部运动时疼痛受限和不稳定。保守治疗往往效果不佳，因此需要手术干预来恢复肘部稳定性。传统上，采用肌腱移植的开放式LUCL重建一直是标准治疗方法，但会造成大量组织破坏且恢复时间延长。关节镜手术提供了一种侵入性较小的替代方案，软组织损伤更小，恢复更快。本技术说明介绍了一种用于治疗PLRI的算法驱动的关节镜辅助技术。利用磁共振成像评估常见伸肌起点的完整性，手术选择包括使用锚钉固定进行LUCL折叠和外侧副韧带重叠缝合。手术过程中，采用微创技术，利用关节镜进行精确的韧带检查和基于锚钉的固定。缝线稳定LUCL和外侧副韧带，解决不稳定问题，同时保留组织完整性。这种方法能够实现术后快速康复，并降低运动受限的风险。虽然适用于1级和2级PLRI，但该技术需要较高的关节镜操作水平。这种微创方法能够有效治疗肘部不稳定，同时促进患者更快康复和长期功能恢复。
