A biomechanical comparison of four reconstruction techniques for the medial collateral ligament-deficient elbow.
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.
Armstrong
April D
AD
Bioengineering Research Laboratory, Hand and Upper Limb Centre, Lawson Health Research Institute, St Joseph's Health Care London, Ontario, Canada.
Dunning
Cynthia E
CE
Ferreira
Louis M
LM
Faber
Kenneth J
KJ
Johnson
James A
JA
King
Graham J W
GJ
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