A biomechanical comparison of four reconstruction techniques for the medial collateral ligament-deficient elbow

• Published in: Journal of shoulder and elbow surgery Vol. 14; no. 2; pp. 207 - 215
• Main Authors: Armstrong, April D., Dunning, Cynthia E., Ferreira, Louis M., Faber, Kenneth J., Johnson, James A., King, Graham J.W.
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01-03-2005; Elsevier
• Subjects: Biological and medical sciences; Bone Screws; Collateral Ligaments - surgery; Diseases of the osteoarticular system; Elbow Joint - surgery; Humans; Medical sciences; Orthopedic Procedures - methods; Prostheses and Implants; Reconstructive Surgical Procedures; Ligament; Interference; Rheumatology; Anatomical reconstruction; Method; Upper extremity; Fixation; Treatment; Screw; Surgery; Upper limb; Peak; Technique; Elbow; Failure; Comparative study; Strength
• ISSN: 1058-2746; 1532-6500
• DOI: 10.1016/j.jse.2004.06.006

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°, 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, β = .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.