Background:

A common concern associated with elbow ulnar collateral ligament (UCL) reconstruction is the amount of time required for recovery and rehabilitation. For example, for Major League Baseball pitchers, the average time to return to competition ranges from 13.8 to 20.5 months. Suture tape augmentation has shown the ability to provide additional soft tissue stability across other joints in the body. By providing an additional checkrein to the UCL reconstruction while the graft is healing, it may be possible to accelerate the rehabilitation process in overhead athletes and thus effect a quicker return to sports.

Purpose:

To compare elbow valgus stability and load to failure between UCL reconstruction with and without suture tape augmentation.

Study Design:

Controlled laboratory study.

Methods:

Fresh-frozen cadaveric elbows (N = 24) were dissected to expose the UCL. Medial elbow stability was tested with the UCL intact, deficient, and reconstructed utilizing the 3-strand docking technique with or without suture augmentation. A 3-N·m valgus torque was applied to the elbow, and valgus rotation of the ulna was recorded via motion-tracking cameras as the elbow was cycled through a full range of motion. After kinematic testing, reconstructed specimens were loaded to failure at 70° of elbow flexion.

Results:

UCL-deficient elbows demonstrated significantly greater valgus rotation when compared with intact and internally braced reconstructed elbows at every angle of flexion tested and when compared with unbraced UCL-reconstructed elbows at 50° to 120° of flexion (P < .05). There were no significant differences between intact and UCL-reconstructed elbows with and without suture augmentation at any flexion angle tested. When loaded to failure, unbraced reconstructed elbows failed at a significantly lower torque as compared with elbows with UCL reconstruction with suture tape augmentation (P < .01).

Conclusion:

In this cadaveric model, 3-strand UCL reconstruction with suture augmentation did not overconstrain the elbow throughout all flexion angles when compared with the native state and UCL reconstruction alone, while providing greater load to failure.

Clinical Relevance:

Suture tape augmentation may provide the additional strength necessary to accelerate rehabilitation after UCL reconstruction.

中文翻译：

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有无缝合增强的尺侧副韧带重建的生物力学比较

背景：

与肘部尺侧副韧带 (UCL) 重建相关的一个常见问题是恢复和康复所需的时间。例如，对于美国职业棒球大联盟的投手来说，重返比赛的平均时间从 13.8 个月到 20.5 个月不等。缝合胶带增强已经显示出能够在身体的其他关节之间提供额外的软组织稳定性。通过在移植物愈合时为 UCL 重建提供额外的检查，可以加速过顶运动员的康复过程，从而更快地恢复运动。

目的：

比较使用和不使用缝合胶带增强的 UCL 重建之间的肘外翻稳定性和负载失败。

学习规划：

受控实验室研究。

方法：

解剖新鲜冷冻的尸体肘部（N = 24）以暴露 UCL。在 UCL 完整、缺陷和重建的情况下测试内侧肘部稳定性，使用 3 股对接技术（有或没有缝合增强）。将 3-N·m 的外翻扭矩施加到肘部，当肘部在整个运动范围内循环时，通过运动跟踪摄像机记录尺骨的外翻旋转。在运动学测试之后，重建的标本在肘部弯曲 70° 时加载到失效。

结果：

与完整和内部支撑的重建肘部相比，UCL 缺陷的肘部在每个测试弯曲角度以及与未支撑的 UCL 重建肘部在 50° 至 120° 弯曲时相比，表现出显着更大的外翻旋转 ( P < .05)。在任何测试的屈曲角度下，有和没有缝合增强的完整和 UCL 重建的肘部之间没有显着差异。当加载到失败时，与使用缝合带增强的 UCL 重建肘部相比，无支撑重建肘部的失败扭矩显着降低 ( P < .01)。

结论：

在这个尸体模型中，与原始状态和单独的 UCL 重建相比，带有缝合增强的 3 股 UCL 重建并没有在所有屈曲角度过度约束肘部，同时提供更大的失败负荷。

临床相关性：

缝合胶带增强可以提供加速 UCL 重建后康复所需的额外强度。