title: A biomechanical comparison of four reconstruction techniques for the medial collateral ligament-deficient elbow.
abstract: The initial strength of the intact medial collateral ligament (MCL) of the elbow and the strength of 4 reconstruction techniques were compared. Twenty cadaveric upper extremities were mounted in a custom jig with the elbow at 90 degrees , and a pneumatic cyclic valgus loading protocol was used. The mean peak load to failure was 142.5+/-39.4 N for the intact ligaments and 53.0+/-9.5 N for the docking reconstructions, 52.5+/-10.4 N for the EndoButton reconstructions, 41.0+/-16.0 N for the interference screw reconstructions, and 33.3+/-7.1 N for the figure-eight reconstructions. The peak load to failure of the MCL reconstructions was inferior compared with the intact ligament (P<.001). No difference in strength was found between the docking and single-strand medial collateral reconstruction with the use of an EndoButton for ulnar fixation (P>.05, beta=.14). Both of these reconstruction methods were stronger than the interference screw or figure-eight technique (P<.004). The optimal fixation method for a single-strand MCL reconstruction may require improved interference screws or a modified EndoButton procedure.
authors.affiliation: Bioengineering Research Laboratory, Hand and Upper Limb Centre, Lawson Health Research Institute, St Joseph's Health Care London, Ontario, Canada.
authors.forename: April D
authors.initials: AD
authors.lastname: Armstrong
authors.forename: Cynthia E
authors.initials: CE
authors.lastname: Dunning
authors.forename: Louis M
authors.initials: LM
authors.lastname: Ferreira
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Faber
authors.forename: James A
authors.initials: JA
authors.lastname: Johnson
authors.forename: Graham J W
authors.initials: GJ
authors.lastname: King
mesh_terms: D001863:Bone Screws; D017885:Collateral Ligaments / Q000601:surgery*; D004551:Elbow Joint / Q000601:surgery*; D006801:Humans; D019637:Orthopedic Procedures / Q000379:methods*; D019736:Prostheses and Implants; D019651:Plastic Surgery Procedures