Clinical Orthopedics and Rheumatology

The Postoperative Management of Medial Collateral Ligament Reconstruction of the Elbow in Athletes

*M. Nagel
Department Of Orthopedic Surgery, Netherlands

*Corresponding Author:
M. Nagel
Department Of Orthopedic Surgery, Netherlands
Email:m.nagel@amc.uva.nl

Published on: 2019-02-07

Abstract

The medial collateral ligament (MCL), or ulnar collateral ligament (UCL), consists of the anterior bundle, the posterior bundle and the transverse ligament. The MCL is the primary constraint to joint valgus forces. Failure of the MCL can result in instability and secondary symptoms as pain, posterior impingement or ulnar nerve symptoms. This often occurs in overhead athletes because of the repeated excessive valgus stress. A lot of research is performed on different surgical techniques for MCL reconstruction such as the Jobe technique and the docking technique. Modifications on these techniques have been made and the most important development is that instead of detaching the origin of the flexor-pronator mass, a muscle splitting approach is used without sub muscular transposition of the ulnar nerve. The rehabilitation after reconstruction is very important. Most physiotherapists use a rehabilitation program based on a 4-phased-protocol described by Wilk et al [1].It is not known which rehabilitation-related factors have an influence on the return to sports and the occurrence of complications. Therefore, more research needs to be done on the postoperative management after MCL reconstruction

Keywords

Elbow in Athletes,Orethopedics

Introduction

The medial collateral ligament (MCL), or the ulnar collateral ligament (UCL), of the elbow is the primary restraint of the elbow joint valgus forces. Failure of the medial collateral ligament of the elbow can be a result of repeated excessive valgus stress, especially in overhead athletes, an acute trauma or acute on chronic trauma. This may result in instability and secondary symptoms such as pain, posterior impingement or ulnar nerve symptoms; this classical triad is often referred to as VEOLS (valgus extension overload syndrome) [2]. As a non-operative management of MCL injuries was career-ending in a significant number of athletes, various types of MCL reconstruction techniques have been developed. The aim of the current review was to provide an overview of the relevant anatomy, surgical techniques and rehabilitation protocols following MCL surgery