Ulnar Collateral Ligament Tear

Ulnar Collateral Ligament Tear

Ulnar Collateral Ligament (UCL) Tear is an uncommon injury in the general population, but is markedly increasing in the athletic population, particularly overhead athletes. The UCL tear results in pain, dysfunction and instability when a dynamic valgus stress is applied to the elbow. The diagnosis is made via clinical exam and MRI and open UCL reconstruction is often recommended for return to sport activities. Multiple techniques have been developed since the initial “Tommy John” surgery. Arthrex has developed the UCL Reconstruction Set, which includes the equipment necessary to perform the different techniques based on surgeon preference.

Ulnar Collateral Ligament (UCL) Tear is an uncommon injury in the general population, but is markedly increasing in the athletic population, particularly overhead athletes. The UCL tear results in pain, dysfunction and instability when a dynamic valgus stress is applied to the elbow. The diagnosis is made via clinical exam and MRI and open UCL reconstruction is often recommended for return to sport activities. Multiple techniques have been developed since the initial “Tommy John” surgery. Arthrex has developed the UCL Reconstruction Set, which includes the equipment necessary to perform the different techniques based on surgeon preference.

DANE TJ Technique

DANE TJ Technique

The DANE TJ (David Altcheck, Neal ElAttrache, Tommy John) Technique is an elbow UCL reconstruction technique that combines proximal graft docking with a single distal interference screw fixation. The DANE TJ Technique can be performed using the Arthrex Elbow UCL Reconstruction Instrument Set. FiberWire and FiberLoop may be used to stitch the graft ends and for final humerus fixation and an Interference Screw for ulna fixation.

Docking Technique

Docking Technique

The “Docking Technique” was first described by Dr. David Altchek. This technique reconstructs the UCL by looping a single continuous graft loop through converging Ulna bone tunnels and “docking” the sutured graft ends through two humeral tunnels, after which the two ends of the UCL graft are tied with non-absorbable suture over a bone bridge. The Docking technique can be performed using the Arthrex ElbowUCL Reconstruction Instrument Set. FiberWire and FiberLoop may be used to stitch the graft ends and for final fixation over the humerus bone bridge.

Interference Screw Technique

Interference Screw Technique

The Interference Screw Technique reconstructs the UCL by using a looped graft anchored into single bone tunnels in the humerus and ulna. The graft is then secured with Arthrex Interference Screws on both sides. FiberWire can also be used for suturing the graft to itself for increased tension and/or original ligament repair for added stabilization.

Modified Jobe Technique

Modified Jobe Technique

The Modified Jobe Technique for UCL Reconstruction/Repair uses a series of tunnels in the ulna and humerus to pass the graft in a figure-8 fashion and secure it to itself and surrounding soft tissue. Repair of the original UCL is added for greater stabilization. The Modified Jobe can be performed using the Arthrex Elbow UCLReconstruction Instrument Set.FiberWire and FiberLoop may be used to stitch the graft ends and for final fixation.

UCL Repair

UCL Repair

Young overhead athletes who sustain an injury to their medial ulnar collateral ligament (UCL) complex, isolated to the proximal or distal end of the ligament and without chronic attritional damage, may benefit from a repair rather than a reconstruction procedure.¹

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