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James R Andrews - One of the best experts on this subject based on the ideXlab platform.

  • Lateral Ulnar Collateral Ligament Reconstruction
    2020
    Co-Authors: Michael G. Saper, Robert J. Schoderbek, Steven W. Meisterling, James R Andrews
    Abstract:

    Reconstruction of the lateral Ulnar Collateral Ligament (LUCL) has been successful in treating posterolateral rotatory instability after a dislocation or recurrent subluxation of the elbow. This chapter offers detailed, step-by-step guidance needed to perform the LUCL reconstruction with the modified O’Driscoll technique.

  • Ulnar Collateral Ligament Reconstruction Using the Modified Jobe Technique
    2020
    Co-Authors: Michael G. Saper, James R Andrews, Benton A. Emblom, Leonard C. Macrina
    Abstract:

    Ulnar Collateral Ligament (UCL) reconstruction has been successful in treating medial elbow instability due to injury to the anterior band of the UCL in high-level overhead athletes. This chapter offers detailed, step-by-step guidance needed to perform the UCL reconstruction using the modified Jobe technique.

  • Ulnar Collateral Ligament injuries in the throwing athlete
    Journal of The American Academy of Orthopaedic Surgeons, 2014
    Co-Authors: Jeremy Bruce, James R Andrews
    Abstract:

    : Repetitive valgus forces on the throwing elbow place significant stress on that joint. This stress can cause structural damage and injury to the Ulnar Collateral Ligament. Many acute injuries of the throwing elbow are caused by repetitive chronic wear. Although much work has been done on injury prevention in youth who are pitchers, overuse injury in throwing sports constitutes an epidemic. Failing nonsurgical management, Ulnar Collateral Ligament reconstruction is a viable option to return the throwing athlete to competition.

  • the Ulnar Collateral Ligament procedure revisited the procedure we use
    Sports Health: A Multidisciplinary Approach, 2012
    Co-Authors: James R Andrews, Patrick W Jost, Lyle E Cain
    Abstract:

    CONTEXT: The Ulnar Collateral Ligament of the elbow (UCL) is frequently injured in throwing athletes, most commonly baseball pitchers. The Ligament is reconstructed through bone tunnels using palmaris longus or gracilis autograft. RESULTS: This study highlights the following technique for UCL reconstruction in over 2000 athletes.(2) CONCLUSION: When conservative management fails, Ligament reconstruction can allow the athlete to return to their sport.(1).

  • MRI of the reconstructed Ulnar Collateral Ligament.
    American Journal of Roentgenology, 2011
    Co-Authors: Shane A. Wear, E. Lyle Cain, D. Dean Thornton, Martin L. Schwartz, Robert C. Weissmann, James R Andrews
    Abstract:

    OBJECTIVE. We are often asked to evaluate the postoperative elbow using MRI. In this article, we present both the normal appearance of the reconstructed Ulnar Collateral Ligament (UCL) and a spectrum of UCL graft abnormalities at MR arthrography. CONCLUSION. The UCL is the primary medial stabilizer of the elbow during flexion and is susceptible to injury, particularly in overhead throwing athletes. In the setting of UCL injury, Ligament reconstruction is the principal surgical procedure available to restore stability and function and to relieve pain with activity. We have found MR arthrography useful in assessing the reconstructed UCL.

Rick W Wright - One of the best experts on this subject based on the ideXlab platform.

  • Ulnar Collateral Ligament reconstruction a systematic review
    Clinical Orthopaedics and Related Research, 2007
    Co-Authors: Derek B Purcell, Matthew J Matava, Rick W Wright
    Abstract:

    Injury to the Ulnar Collateral Ligament of the elbow is a commonly recognized lesion in the overhead throwing athlete. The techniques for reconstruction of this critical Ligament have evolved over time. The outcomes of Ulnar Collateral Ligament reconstruction were assessed for success. We systematic

  • biomechanical evaluation of 2 techniques for Ulnar Collateral Ligament reconstruction of the elbow
    American Journal of Sports Medicine, 2006
    Co-Authors: George A Paletta, Steven Klepps, Gregory S Difelice, Tracy Allen, Michael D Brodt, Meghan E Burns, Matthew J Silva, Rick W Wright
    Abstract:

    BACKGROUND: Elbow medial Ulnar Collateral Ligament tears often result in pain and instability that may be career threatening in overhead-throwing athletes. Surgical reconstruction is frequently chosen to treat this injury. Ulnar Collateral Ligament reconstruction as described by Jobe is the most commonly used technique. Testing of this construct has not demonstrated that the biomechanical parameters of the native Ligament are restored. A more recent construct, the docking technique, may more reliably reproduce these factors. HYPOTHESIS: Increasing the number of strands of palmaris longus tendon graft used in Ulnar Collateral Ligament reconstruction and tensioning them using the docking technique result in a construct with improved biomechanical parameters as compared with the Jobe technique. STUDY DESIGN: Controlled laboratory study. METHODS: Thirty-three fresh-frozen human cadaveric elbows were randomized into 3 subgroups: Jobe (11), docking (12), and native (10). The Jobe and docking groups underwent reconstruction using their described palmaris tendon graft constructs. The Ulnar Collateral Ligament was left intact in the native group. Elbows were potted and tested using a servohydraulic materials testing machine to apply a valgus moment at 30 degrees of elbow flexion. Maximal moments to failure, stiffness, and strain at maximal moment and with a 3 N.m force applied were determined using a 2-camera motion analysis system to track reflective markers spanning the site. RESULTS: The docking (14.3 N.m) and native (18.8 N.m) subgroups resulted in higher maximal moment to failure than did the Jobe (8.9 N.m) subgroup (P .05). Native Ligaments were stiffer (301.4 N.m) than were Jobe (74.3 N.m) or docking (80.8 N.m; P .05). CONCLUSION: Neither technique reproduced the biomechanical profile of the native Ulnar Collateral Ligament; the findings of this study suggest that the docking construct may offer initial biomechanical advantage over the Jobe construct.

  • the modified docking procedure for elbow Ulnar Collateral Ligament reconstruction 2 year follow up in elite throwers
    American Journal of Sports Medicine, 2006
    Co-Authors: George A Paletta, Rick W Wright
    Abstract:

    BackgroundUlnar Collateral Ligament injury is most common in the overhead-throwing athlete. Jobe et al published the first report of Ulnar Collateral Ligament reconstruction in throwing athletes with a 62.5% success rate. Recently, Altchek developed a new docking technique for reconstruction of the Ulnar Collateral Ligament. The authors report the first series using a further modification of the docking technique using a 4-strand palmaris longus graft for reconstruction of the Ulnar Collateral Ligament.HypothesisThe modified docking technique yields a high rate of successful return to preinjury level of competition in elite baseball players.Study DesignCase series; Level of evidence, 4.MethodsThe authors retrospectively reviewed 25 elite professional or scholarship collegiate baseball players who underwent elbow Ulnar Collateral Ligament reconstruction using the modified docking procedure with a minimum 2-year follow-up.ResultsTwenty-three of 25 (92%) were able to return to their preinjury levels of compe...

Joshua S. Dines - One of the best experts on this subject based on the ideXlab platform.

Christopher S Ahmad - One of the best experts on this subject based on the ideXlab platform.

  • Professional and Amateur Pitchers' Perspective on the Ulnar Collateral Ligament Injury Risk.
    Orthopaedic Journal of Sports Medicine, 2019
    Co-Authors: Danica D. Vance, Frank J. Alexander, Brian W. Kunkle, Mark Littlefield, Christopher S Ahmad
    Abstract:

    Background: Medial Ulnar Collateral Ligament (UCL) injury is increasingly prevalent in professional baseball pitchers, and significant research has been devoted to understanding the risk factors an...

  • Ulnar nerve complications after Ulnar Collateral Ligament reconstruction of the elbow a systematic review
    American Journal of Sports Medicine, 2019
    Co-Authors: Jason B Clain, Christopher S Ahmad, Mark A Vitale, David E Ruchelsman
    Abstract:

    Background:While Ulnar Collateral Ligament reconstruction (UCLR) of the elbow is an increasingly commonly performed procedure with excellent results reported in the published literature, less atten...

  • Rehabilitation Variability After Elbow Ulnar Collateral Ligament Reconstruction.
    Orthopaedic Journal of Sports Medicine, 2019
    Co-Authors: Harry M. Lightsey, David P. Trofa, Julian J. Sonnenfeld, Hasani W. Swindell, Eric C. Makhni, Christopher S Ahmad
    Abstract:

    Background:Investigations specifically delineating the safest and most efficacious components of physical therapy after Ulnar Collateral Ligament (UCL) reconstruction of the elbow are lacking. As s...

  • clinical outcomes of the dane tj technique to treat Ulnar Collateral Ligament insufficiency of the elbow
    American Journal of Sports Medicine, 2007
    Co-Authors: Joshua S. Dines, Neal S Elattrache, John E Conway, Wade Smith, Christopher S Ahmad
    Abstract:

    Background: Many improvements in Ulnar Collateral Ligament reconstruction have been made since Jobe et al first described the procedure. A novel elbow Ulnar Collateral Ligament reconstruction technique that combines interference screw fixation on the ulna with docking of the graft on the humeral side (DANE TJ) has been reported.Hypothesis: Outcomes of Ulnar Collateral Ligament reconstructions performed with the DANE TJ technique are as good as other recently published results of Ulnar Collateral Ligament reconstruction, particularly in cases of insufficient bone stock on the sublime tubercle and revision reconstructions.Study Design: Case series; Level of evidence, 4.Methods: During a 3-year period, 22 athletes were treated with surgical reconstruction of the Ulnar Collateral Ligament using proximal docking and distal interference screw fixation of the Ligament (DANE TJ technique). All patients had a history, physical examination findings, and magnetic resonance imaging results consistent with Ulnar colla...

  • elbow medial Ulnar Collateral Ligament insufficiency alters posteromedial olecranon contact
    American Journal of Sports Medicine, 2004
    Co-Authors: Christopher S Ahmad, Maxwell C Park, Neal S Elattrache
    Abstract:

    Background: The effect of elbow medial Ulnar Collateral Ligament injury on posteromedial compartment contact is unknown.Hypothesis: Medial Ulnar Collateral Ligament injury causes altered contact area and pressure in the posteromedial compartment of the elbow.Study Design: Controlled laboratory study.Methods: Seven elbow cadaveric specimens were tested in an apparatus that positioned the elbow at 30° and 90° of flexion. Partial and full tears were simulated by releasing the medial Ulnar Collateral Ligament. Pressure-sensitive film was placed in the posteromedial compartment for each condition. Valgus torques of 1.25 and 2.0 N.m were applied for each Ligament condition, and kinematic data were obtained at each flexion angle using a 3-dimensional digitizer.Results: Both Ligament condition and valgus load had significant effects on contact area and pressure (P < .05). For a given load and flexion angle, the contact area decreased and the pressure increased with increasing medial Ulnar Collateral Ligament insu...

Jeffrey R. Dugas - One of the best experts on this subject based on the ideXlab platform.

  • Baseball Pitching Biomechanics Shortly After Ulnar Collateral Ligament Repair
    Orthopaedic Journal of Sports Medicine, 2019
    Co-Authors: Glenn S Fleisig, E. Lyle Cain, Alek Z. Diffendaffer, Monika Drogosz, Benton A. Emblom, Jeffrey R. Dugas
    Abstract:

    Background:The probability of returning to competition for injured baseball pitchers is similar after Ulnar Collateral Ligament (UCL) repair as after UCL reconstruction, but the time to return is s...

  • Ulnar Collateral Ligament Repair.
    Orthopedic Clinics of North America, 2019
    Co-Authors: A. Ryves Moore, Glenn S Fleisig, Jeffrey R. Dugas
    Abstract:

    : The anterior bundle of the Ulnar Collateral Ligament (UCL) is the primary restraint to valgus force at the elbow, especially during the arm-cocking and arm-acceleration phases of the overheard throwing cycle. Injuries of the UCL can range from partial thickness tears, end avulsions, to chronic attritional ruptures with poor tissue quality. The incidence of UCL injuries is on the increase, especially among adolescent overhead athletes. If the athlete fails conservative measures, surgery is recommended for those desiring to return to overhead sports. Over the past 40 years, UCL reconstruction has been the gold standard for all varieties of UCL injuries.

  • Repair of the Ulnar Collateral Ligament of the Elbow: Rehabilitation Following Internal Brace Surgery
    Journal of Orthopaedic & Sports Physical Therapy, 2019
    Co-Authors: Kevin E. Wilk, Marcus A. Rothermich, Christopher A. Arrigo, Michael S. Bagwell, Jeffrey R. Dugas
    Abstract:

    Synopsis Injuries to the elbow in athletes who play overhead sports, especially in baseball pitchers, continue to increase in frequency. The anterior band of the Ulnar Collateral Ligament (UCL), th...

  • Incidence of Elbow Ulnar Collateral Ligament Surgery in Collegiate Baseball Players.
    Orthopaedic Journal of Sports Medicine, 2018
    Co-Authors: Marcus A. Rothermich, E. Lyle Cain, Glenn S Fleisig, Stan Conte, Kyle T. Aune, Jeffrey R. Dugas
    Abstract:

    Background:Recent reports have highlighted the progressive increase in the incidence of Ulnar Collateral Ligament (UCL) injuries to the elbow in baseball players of all levels. However, knowledge o...

  • anatomy of the anterior bundle of the Ulnar Collateral Ligament
    Journal of Shoulder and Elbow Surgery, 2007
    Co-Authors: Jeffrey R. Dugas, Roger V Ostrander, Lyle E Cain, David Kingsley, James R Andrews
    Abstract:

    The purpose of this project was to study the anatomy of the anterior bundle of the Ulnar Collateral Ligament and provide anatomic measurements not previously described. Thirteen fresh-frozen cadaver elbows were dissected. A 3-dimensional, electromagnetic, digitizing device was used to measure several anatomic parameters of the anterior bundle of the Ulnar Collateral Ligament. The width of the Ligament was not uniform, increasing distally toward the insertion. The average area of the origin was 45.5 mm 2 , and the average area of the insertion was 127.8 mm 2 . The edge of the insertion was separated from the ulna articular margin by an average of 2.8 mm. The study provides quantitative data describing the anatomy of the anterior bundle of the Ulnar Collateral Ligament. This information may prove useful in surgical techniques designed to reproduce the anatomy and biomechanics of the elbow after injury.