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.

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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.

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DANE TJ Technique
TheDANE TJ (David Altcheck, Neal ElAttrache, Tommy John) Technique is an elbow UCL reconstructiontechnique that combines proximal graft docking with a single distalinterference 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 andfor final humerus fixation and an Interference Screw for ulna fixation.
Docking Technique
The “DockingTechnique” was first described by Dr. David Altchek. This techniquereconstructs the UCL by looping a single continuous graft loop throughconverging Ulna bone tunnels and “docking” the sutured graft ends through twohumeral tunnels, after which the two ends of the UCL graft are tied withnon-absorbable suture over a bone bridge. The Dockingtechnique can be performed using the Arthrex ElbowUCL Reconstruction Instrument Set. FiberWireand FiberLoop may be used to stitch the graft ends and for final fixation overthe humerus bone bridge.
Interference Screw Technique
TheInterference Screw Technique reconstructs the UCL by using a looped graftanchored into single bone tunnels in the humerus and ulna. The graft is thensecured with Arthrex Interference Screws on both sides. FiberWire can also beused for suturing the graft to itself for increased tension and/or originalligament repair for added stabilization.
Modified Jobe Technique
The ModifiedJobe 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 toitself and surrounding soft tissue. Repair of the original UCL is added forgreater stabilization. The Modified Jobe canbe performed using the Arthrex Elbow UCLReconstruction Instrument Set.FiberWire and FiberLoop may be used to stitch the graft ends andfor final fixation.
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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