title: Rehabilitation, clinical outcome and return to sporting activities after posterolateral elbow instability: a systematic review.
abstract: BACKGROUND
  The aim of this study was to systematically review the literature for rehabilitation concepts, clinical outcome and sporting performance after surgical or non-surgical treatment of Posterolateral Rotatory Instability of the elbow (PLRI).
  
  
  METHODS
  In order to identify any published clinical study reporting on rehabilitation concepts and sporting performance following surgical or non-surgical treatment of PLRI a systematic search in literature was conducted. Rehabilitation protocols were reviewed according to main rehabilitation protocol categories (bracing, range of motion [ROM], strengthening and return to sport [RTS]).
  
  
  RESULTS
  Seven articles, including 148 patients met the inclusion criteria. Lateral ulnar collateral ligament (LUCL) repair with sutures or suture anchors was reported in two studies. In four studies, treatment was an isolated graft reconstruction and in one study a repair or graft reconstruction was performed. No study reporting on conservative treatment was found. Bracing with initially limiting ROM was declared in all studies. Duration of immobilization varied from one day to six weeks postoperative. Limitation of ROM to 30° of elbow extension was reported in the majority of studies. Strengthening was allowed from six to eight weeks postoperative. Postoperative improvement in elbow range of motion was noted in all studies.
  
  
  CONCLUSIONS
  Although there is agreement concerning bracing and limiting ROM following PLRI surgery there is currently no consensus in the rehabilitative- and conservative treatment modalities for patients with symptomatic PLRI. The majority of surgically treated patients with PLRI regain high acceptable results but further research is needed to determine the postoperative level of performance of these athletes.
authors.affiliation: Department for Orthopedic Sports Medicine, Technical University of Munich, Munich, Germany - sven.reuter@mri.tum.de.
authors.forename: Sven
authors.initials: S
authors.lastname: Reuter
authors.affiliation: Department for Orthopedic Sports Medicine, Technical University of Munich, Munich, Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Proier
authors.affiliation: Department for Orthopedic Sports Medicine, Technical University of Munich, Munich, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Imhoff
authors.affiliation: Department for Orthopedic Sports Medicine, Technical University of Munich, Munich, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Lenich
mesh_terms: D001915:Braces; D003131:Combined Modality Therapy; D004551:Elbow Joint / Q000601:surgery*; D005081:Exercise Therapy; D006801:Humans; D007593:Joint Instability / Q000534:rehabilitation* / Q000601:surgery*; D008023:Ligaments, Articular / Q000293:injuries* / Q000601:surgery*; D016059:Range of Motion, Articular; D000068958:Return to Sport; D011795:Surveys and Questionnaires; D000092464:Elbow Injuries