Suture Tape Augmentation Speeds Up UCLR Recovery

Ulnar collateral ligament reconstruction (UCLR) with suture tape augmentation adds strength and speeds up rehab for athletes, a new study finds.

The study, “Biomechanical Comparison of Ulnar Collateral Ligament Reconstruction With and Without Suture Augmentation,” was published online on June 20, 2022 in The American Journal of Sports Medicine.

“A common concern associated with elbow ulnar collateral ligament reconstruction is the amount of time required for recovery and rehabilitation. For example, for Major League pitchers, the average time to return to competition ranges from 13.8 to 20.5 months,” the researchers wrote.

“Suture tape augmentation has shown the ability to provide additional soft tissue stability across other joints in the body. By providing an additional checkrein to the UCL reconstruction while the graft is healing, it may be possible to accelerate the rehabilitation process in overhead athletes and thus effect a quicker return to sports.”

Using 24 fresh-frozen cadaveric elbows, the researchers compared elbow valgus stability and load to failure between UCL reconstruction with and without suture tape augmentation.

First, medial elbow stability was tested with the UCL intact, deficient, and reconstructed using the 3-strand docking technique with or without suture augmentation. Then a 3-N m valgus torque was applied to the elbow and valgus rotation of the ulna was recorded via motion-tracking cameras. The reconstructed specimens were also loaded to failure at 70° of elbow flexion.

The UCL-deficient elbows had greater valgus rotation compared with intact and internally braced reconstructed elbows at every angle of flexion tested and also when compared with unbraced UCL-reconstructed elbows at 50° to 120° of flexion (p < .05).

The researchers discovered no significant differences between intact and UCL-reconstructed elbows with and without suture augmentation at any flexion angle tested. When loaded to failure, the unbraced reconstructed elbows failed at a significantly lower torque as compared with elbows with UCL reconstruction with suture tape augmentation (p < .01).

“In this cadaveric model, 3-strand UCL reconstruction with suture augmentation did not over constrain the elbow throughout all flexion angles when compared with the native state and UCL reconstruction alone, while providing greater load to failure.,” they explained.

Study authors included Michael V. Narvaez, M.D., Trevor J. Nelson, B.S., Keon Youssefzadeh, B.S., Orr Limpisvasti, M.D., and Melodie F. Metzger, Ph.D., all of Cedars-Sinai, Los Angeles, California.