Die ligamentäre Instabilität des Ellenbogens: Biomechanische Untersuchungen zur Wertigkeit aktueller Techniken der medialen und lateralen Kollateralbandrekonstruktion

SummaryOpen surgical reconstruction of the ulnar and lateral ulnar collateral ligament are standard procedures in patients with symptomatic medial or posterolateral rotatory instability of the elbow. There is, however, a considerable discrepancy between the in vivo moments acting on the ulnar or lateral collateral ligament complex during overhead sports activities and the primary stability of current reconstructive methods. This biomechanical study aimed to increase the primary stability of ulnar and lateral ulnar collateral ligament reconstruction either by increasing the diameter of the graft or by using a percutaneous reconstruction procedure which preserves the lateral elbow muscles as important stabilizers of the elbow joint. The results showed that increasing the graft diameter did not provide greater valgus stability because graft passage and graft tensioning was complicated using larger grafts. As the graft diameter did not influence primary valgus stability, future clinical studies should focus on the stabilizing potential of the medial elbow muscles on the valgus stability of the elbow joint. Percutaneous lateral ulnar ligament reconstruction sufficiently restored posterolateral rotatory instability, but clinical trials are needed to prove that preservation of the lateral elbow muscles allows for accelerated rehabilitation and return to sports activities.