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2023 AOSSM Annual Meeting Recordings with CME
Functional Outcomes of Primary Ulnar Collateral Li ...
Functional Outcomes of Primary Ulnar Collateral Ligament Repair with Internal Bracing in Athletes
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Video Transcription
And also thanks for presenting a lot of the relevant literature related to our talk. So that's fresh in everyone's mind. As I mentioned, big thanks to Ben Lynch for the opportunity to present. These are our disclosures which are also available on the academy website. As we've discussed already this morning, UCL injuries are increasing. The popularity of repair is also increasing as patients become more familiar with it and are interested in potentially accelerated return to play. So the purpose of our study was to look at outcomes in a cohort of baseball players who underwent a UCL repair with suture augmentation. We retrospectively reviewed a prospectively collected registry and looked at these outcomes. We also did a subgroup analysis to look at if any patient factors, surgical factors led to changes in return to play or complications. Our indications were a focal, distal or proximal tear. We also assessed the ligament as mentioned at the time of surgery. All patients who were indicated for repair were also consented for a reconstruction. This is one example of a hopeful repair candidate who underwent a reconstruction due to the quality of the ligament. Briefly in terms of the technique, also muscle splitting, incising the ligament in a 3-5 anchor at the sublime tubercle with a collagen-coated fiber tape. Proximally diverging tunnels were drilled with a 2-0 drill to tie the suture brace over a bone bridge at the epicondyle. The sutures were passed from distal to proximal with a suture tape followed by zero non-absorbable high tensile sutures. And in the cases of a proximal tear, a suture tape was placed proximally and then passed through bone tunnels to tie over the epicondyle, completed repair of a proximal tear as shown in the right photo. Range of motion was always tested to ensure adequate isometry afterwards. So jumping into our results, we had the majority of pitchers as is typical in these studies. We had two patients who had a concomitant nerve transposition and several more who had a posterior debridement. The return-to-play rate was almost identical to the study presented just before us by Dr. Dugas of 92%. And the timeframe was slightly longer than that at 8 months. There were no difference in our subgroup analysis looking at different patient and surgical characteristics and their impact on outcomes. Drilling down a little bit into the patients who didn't return to sport or had a re-operation, we had four failures of return-to-play. Two of them were high school pitchers who lost their interest in competitive baseball sometime in the rehabilitation process. One player that's still trying to get back after a couple setbacks. And we had one pitcher who after 12 months of rehab from the UCL repair ended up undergoing a reconstruction and is still trying to get back at this point in time. He is one of four patients who had a re-operation. The other three were players who did get back to play, but two that required subsequent nerve transposition and one a posterior debridement. So the limitations are typical of a case series in a single surgeon. We're hoping to have performance metrics and PROs to present at a future date for this cohort as well. So just to summarize, a high rate of return-to-play similar to the previous reported case series with also a similar timeframe of return-to-play and then this one instance of revision reconstruction. Thank you very much. »» Thank you.
Video Summary
The video discussed a study on outcomes in baseball players who underwent a UCL (ulnar collateral ligament) repair with suture augmentation. The study retrospectively reviewed a prospectively collected registry and found that the return-to-play rate was 92%, with a timeframe of 8 months. There were no significant differences in outcomes based on patient and surgical characteristics. Four patients had re-operations, with one undergoing a reconstruction after 12 months of rehab. The study has limitations as a single surgeon case series. Overall, the study showed a high rate of return-to-play with a similar timeframe compared to previous studies. The transcript ends with gratitude to Ben Lynch and disclosure information. No additional credits were mentioned in the transcript.
Asset Caption
Alan W. Reynolds, MD
Keywords
baseball players
UCL repair
suture augmentation
return-to-play rate
re-operations
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