Biomechanical assessment of lateral ulnar collateral ligament repair and reconstruction with or without internal brace augmentation

© 2020 The Authors.

Bibliographische Detailangaben
Veröffentlicht in:JSES international. - 2020. - 4(2020), 2 vom: 01. Juni, Seite 224-230
1. Verfasser: Melbourne, Craig (VerfasserIn)
Weitere Verfasser: Cook, James L, Della Rocca, Gregory J, Loftis, Christopher, Konicek, John, Smith, Matthew J
Format: Online-Aufsatz
Sprache:English
Veröffentlicht: 2020
Zugriff auf das übergeordnete Werk:JSES international
Schlagworte:Journal Article Elbow internal brace lateral ulnar collateral ligament posterolateral rotatory instability suture tape augmentation tendon reconstruction
Beschreibung
Zusammenfassung:© 2020 The Authors.
BACKGROUND: Surgical treatment of posterolateral rotatory instability (PLRI) using primary repair or reconstruction of the lateral collateral ligament complex have proven inconsistent. This study aimed to test the hypothesis that augmentation of LUCL repair or palmaris longus tendon reconstruction using a suture tape augmentation would be associated with less rotational displacement and greater torque load to failure (LTF) compared with nonaugmented constructs
METHODS: Cadaveric elbows (n = 12 matched pairs) were used. Baseline stiffness and displacement values were obtained. The LUCL was transected followed by repair alone, repair with augmentation, reconstruction with palmaris longus graft, or reconstruction with augmentation. Specimens were retested including torque LTF. Paired t tests were performed to assess the biomechanical effects of augmentation
RESULTS: Augmentation was associated with higher LTF than repair and reconstruction alone (P = .008 and .047, respectively). Displacement was less with augmentation in reconstruction groups (P = .048) but not in repair groups. Suture tape augmentation maintained rotational stiffness better than repair alone (P = .01). Although reconstruction with augmentation maintained rotational stiffness better than nonaugmented reconstruction, the differences were not statistically significant (P = .057). Mode of failure for repair alone was predominantly suture pulling through repaired ligament. Augmented repairs primarily failed at the anchor-bone interface. Modes of failure for both reconstruction groups were similar, including graft tearing and/or slipping at the anchor
CONCLUSION: When positioned in neutral forearm rotation and 90o of flexion to simulate postoperative conditions, augmentation of LUCL repair or tendon reconstruction using suture tape is associated with better resistance to rotational loads compared with nonaugmented repair or reconstruction, while maintaining near-native rotational stiffness
Beschreibung:Date Revised 14.04.2022
published: Electronic-eCollection
Citation Status PubMed-not-MEDLINE
ISSN:2666-6383
DOI:10.1016/j.jseint.2020.01.011