tunnels and sutured over a bone bridge. The common points of failure associated with the docking method is suture pullout or fracture of the bone tunnel, both of which are highlighted in red here. Recently a double button technique was introduced which uses cortical buttons to tension the graft at both ulnar and humeral attachments using only a single bone tunnel. Theoretically, this method should eliminate the points of failure associated with the docking method as the buttons eliminate the use of the suture and also the use of only a single bone tunnel with increased thickness would eliminate fracture. We recently published a biomechanical study that evaluated the performance of the double button method compared to the docking method and showed that both have comparable joint stiffness, stability and strength. However, there have been no clinical studies that compare the two. Therefore this study, we were looking to perform a comparison of the clinical outcomes in baseball players that have undergone UCLR using the docking method versus the double button method. We hypothesized that there would be no difference between the two methods in terms of return to sport rates and time. This was a retrospective cohort study across two institutions where we included professional baseball players who underwent UCLR because of a throwing injury. In terms of demographics, we performed a chart review to find demographics such as the graft type and UCL severity as seen here and also the level of competitiveness of baseball playing and the position that they played. We also screened for complications, re-operations or revisions and sent them a red cap survey to look for patient reported outcome measures, including the CAGEOC score. In terms of demographics, 78 baseball players were included on this study with an average age of 19 years and 71% of those players returned the functional outcome surveys. In terms of demographics, we found that players in the double button group more frequently received the Palmaris Longest as an autograft, but other than that, there were no differences in their demographics. There were also no differences between the two groups in terms of their return to sport. We saw that 100% of the double button players were able to return to sport and 96% of players in the docking group were able to return to sport. Additionally, there were no differences in months to return to play with 11 months for the double button group and 13 and a half months for the docking group. We did not see any differences in the scores between the two groups either. Of note, the double button group had a CAGEOC score of 84 while the docking group had a CAGEOC score of 77. Both groups had a satisfaction score of 93%. The limitations of the study were that only 10 of the players in the double button group responded to the patient satisfaction surveys and only 71% of the players across both groups responded to those surveys as well. Additionally, the retrospective study design of this study limited our ability to compare the performance of or compare their function before and after the procedure. Also a randomized control trial in the future would be great in determining or better in comparison, better to compare the two techniques. In conclusion, our hypothesis was confirmed in that there is no difference in clinical outcomes between the two studies and this is the first study that compared the double button method or functional outcomes of the double button method with the docking technique. Thank you and I'd like to thank all my co-authors and AOSSM for having me. Thank you, Richard. Thank you.

surgical techniques

ulnar collateral ligament reconstruction

UCLR

docking method

double button technique