title: [Lateral ulnar collateral ligament reconstruction : A biomechanical analysis of posterolateral rotatory instability of the elbow].
abstract: BACKGROUND
  Chronic posterolateral rotatory instability (PLRI) of the elbow is the result of an insufficiency of the lateral collateral ligament (LCL). Lateral ulnar collateral ligament (LUCL) reconstruction represents a well-established treatment method for PLRI. However, recurrent instability remains a problem.
  
  
  OBJECTIVE
  The goal of this in-vitro study was to evaluate the posterolateral rotatory stability of the intact elbow, after sectioning of the LCL and after LUCL reconstruction with a triceps tendon autograft and double BicepsButton(TM) fixation.
  
  
  METHODS
  Posterolateral rotatory stability of 6 fresh-frozen elbow specimens at a torque of 3 Nm was analyzed at 0, 45, 90 and 120° of flexion for the intact LCL, after sectioning of the LCL and after LUCL reconstruction. Moreover, cyclic loading (1000 cycles) of the intact specimens and after LUCL reconstruction was performed.
  
  
  RESULTS
  The intact LCL and the LUCL reconstruction provided equal primary stability (0.250 ≤ p ≤ 0.888). Sectioning of the LCL significantly increased PLRI (p < 0.001). The stability of the intact specimens and after LUCL reconstruction did not differ after cyclic loading (p = 0.218). During cyclic loading, posterolateral rotation increased significantly more after LUCL reconstruction (3.2 ± 0.8°) when compared to the native LCL (2.0 ± 0.7°, p = 0.020).
  
  
  CONCLUSIONS
  LUCL reconstruction with BicepsButton(TM) fixation provides comparable stability to the native LCL. Further clinical results are necessary to evaluate whether this technique can decrease the complication rate.
authors: Institut I für Anatomie, Universität zu Köln, Köln, Deutschland. michael.hackl@uk-koeln.de.|Schwerpunkt für Unfall-, Hand- und Ellenbogenchirurgie, Universitätsklinik zu Köln, Kerpener Straße 62, 50937, Köln, Deutschland. michael.hackl@uk-koeln.de.|Cologne Center for Musculoskeletal Biomechanics (CCMB), Universität zu Köln, Köln, Deutschland. michael.hackl@uk-koeln.de.
authors: M
authors: M
authors: Hackl
authors: Schwerpunkt für Unfall-, Hand- und Ellenbogenchirurgie, Universitätsklinik zu Köln, Kerpener Straße 62, 50937, Köln, Deutschland.|Cologne Center for Musculoskeletal Biomechanics (CCMB), Universität zu Köln, Köln, Deutschland.
authors: T
authors: T
authors: Leschinger
authors: Schwerpunkt für Unfall-, Hand- und Ellenbogenchirurgie, Universitätsklinik zu Köln, Kerpener Straße 62, 50937, Köln, Deutschland.|Cologne Center for Musculoskeletal Biomechanics (CCMB), Universität zu Köln, Köln, Deutschland.
authors: C
authors: C
authors: Ries
authors: Institut I für Anatomie, Universität zu Köln, Köln, Deutschland.
authors: W F
authors: WF
authors: Neiss
authors: Schwerpunkt für Unfall-, Hand- und Ellenbogenchirurgie, Universitätsklinik zu Köln, Kerpener Straße 62, 50937, Köln, Deutschland.|Cologne Center for Musculoskeletal Biomechanics (CCMB), Universität zu Köln, Köln, Deutschland.
authors: L P
authors: LP
authors: Müller
authors: Schwerpunkt für Unfall-, Hand- und Ellenbogenchirurgie, Universitätsklinik zu Köln, Kerpener Straße 62, 50937, Köln, Deutschland.|Cologne Center for Musculoskeletal Biomechanics (CCMB), Universität zu Köln, Köln, Deutschland.
authors: K
authors: K
authors: Wegmann
mesh_terms: D000368:Aged; D002102:Cadaver; D000070637:Collateral Ligament, Ulnar / Q000293:injuries* / Q000503:physiopathology* / Q000601:surgery; D004551:Elbow Joint / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000503:physiopathology* / Q000601:surgery*; D008297:Male; D008954:Models, Biological; D016059:Range of Motion, Articular; D012399:Rotation; D013718:Tensile Strength; D016896:Treatment Outcome; D000070638:Ulnar Collateral Ligament Reconstruction / Q000379:methods*; D000092464:Elbow Injuries
keywords: Elbow; Instability; Ligament reconstruction; Ligaments, collateral