Medial collateral ligament reconstruction of the elbow using the docking technique.
BACKGROUND
Medial collateral ligament insufficiency of the elbow with resultant valgus instability in throwing athletes is typically treated with free tendon graft reconstruction as described by Jobe.


OBJECTIVE
Improved results could be obtained with the use of the docking technique.


METHODS
Uncontrolled retrospective review.


METHODS
The study group consisted of 36 athletes who had symptomatic insufficiency of the medial collateral ligament confirmed by magnetic resonance imaging and by surgical findings. Average follow-up was 3.3 years. Key elements of the docking technique included a muscle-splitting approach without routine transposition of the ulnar nerve, routine arthroscopic assessment, treatment of associated lesions, and docking the two ends of the tendon graft into a single humeral tunnel.


RESULTS
Thirty-three of 36 patients (92%) returned to or exceeded their previous level of competition for at least 1 year, meeting the Conway-Jobe classification criteria of "excellent." All 22 professional or collegiate athletes returned to or exceeded their previous competition level.


CONCLUSIONS
The docking technique allowed simplified graft tensioning and improved graft fixation.
Rohrbough
Joel T
JT
Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, New York 10021, USA.
Altchek
David W
DW
Hyman
Jon
J
Williams
Riley J
RJ
Botts
Jonathan D
JD
D000293:Adolescent; D000328:Adult; D001182:Arthroscopy; D001484:Baseball / Q000293:injuries*; D017885:Collateral Ligaments / Q000601:surgery*; D004551:Elbow Joint / Q000601:surgery*; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000534:rehabilitation / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures; D011182:Postoperative Care; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies