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Ulnar Collateral Ligament Reconstruction: A Systematic Review

Injury to the ulnar collateral ligament of the elbow is a commonly recognized lesion in the overhead throwing athlete. The techniques for reconstruction of this critical ligament have evolved over time. The outcomes of ulnar collateral ligament reconstruction were assessed for success. We systematically reviewed the literature and found five Level III retrospective cohort studies that reported outcomes after reconstruction. One study reflected shorter term followup on a cohort that was included in a later study. Successful outcomes were based primarily on the return to play level of the athlete. Articles were reviewed with regard to population, followup, operative technique, adjunctive procedures, complications, and outcomes. The figure-of-eight and docking techniques for ulnar collateral ligament reconstructions provide high levels of return to sport for the overhead athlete. The most common complications were associated with the ulnar nerve. Transition to the muscle-splitting approach has decreased the occurrence of these complications. Areas for future research are also discussed.Level of Evidence: Level III, systematic review. See Guidelines for Authors for a complete description of levels of evidence.