Arthroscopic Lateral Ulnar Collateral Ligament Plication/Reconstruction With Augmented Lateral Collateral Ligament Imbrication

Arthroscopy Techniques, vol. 14, pp. 103529

Abstract

Posterolateral rotatory instability (PLRI) is a chronic condition resulting from damage to the lateral ulnar collateral ligament (LUCL) and related structures causing painful restrictions and instability in elbow movement. Conservative treatment often falls short, necessitating surgical intervention to restore elbow stability. Traditionally, open LUCL reconstruction with tendon grafting has been the standard of care but involves substantial tissue disruption and extended recovery. Arthroscopic approaches offer a less-invasive alternative with reduced soft-tissue damage and faster recovery. This Technical Note presents an algorithm-driven, arthroscopically assisted technique for PLRI treatment. Using magnetic resonance imaging to evaluate the common extensor origin's integrity, surgical options include LUCL plication with anchor fixation and lateral collateral ligament imbrication. During surgery, a minimally invasive technique is employed leveraging arthroscopy for precise ligament inspection and anchor-based fixation. Sutures stabilize the LUCL and lateral collateral ligament, addressing instability while preserving tissue integrity. This approach enables rapid postoperative rehabilitation and reduces the risk of motion restrictions. Although suitable for grade 1 and 2 PLRI, the technique demands high arthroscopic proficiency. This minimally invasive method allows effective management of elbow instability while promoting quicker patient recovery and long-term functional restoration.

Authors 7

1. Christos Koukos
   Affiliation as printed

   Sports Trauma and Pain Institute Thessaloniki Greece

   Sports Trauma and Pain Institute, Thessaloniki, Greece

2. Dominique Schoeps corresponding

   Düsseldorf University Hospital

   Affiliation as printed

   Department of Trauma Surgery and Orthopaedics University Hospital Düsseldorf Düsseldorf Germany

   Department of Trauma Surgery and Orthopaedics, University Hospital Düsseldorf, Düsseldorf, Germany

3. Joachim Windolf Aachen

   Universitätsklinikum Aachen

   Affiliation as printed

   University Hospital Aachen Aachen Germany

   University Hospital Aachen, Aachen, Germany

4. In‐Ho Jeon

   Asan Medical Center · University of Ulsan

   Affiliation as printed

   Department of Orthopaedic Surgery Asan Medical Center University of Ulsan Seoul Republic of Korea

   Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan, Seoul, Republic of Korea

5. Cristina Zolog
   Affiliation as printed

   Department of Special Sports Surgery Wuppertal Germany

   Department of Special Sports Surgery, Wuppertal, Germany

6. Konstantinos T. Ditsios

   Aristotle University of Thessaloniki

   Affiliation as printed

   2nd Orthopaedic Department of Aristotle University of Thessaloniki “G Gennimatas” Hospital Thessaloniki Greece

   2nd Orthopaedic Department of Aristotle, University of Thessaloniki, "G Gennimatas" Hospital, Thessaloniki, Greece

7. David Latz

   Düsseldorf University Hospital

   Affiliation as printed

   Department of Trauma Surgery and Orthopaedics University Hospital Düsseldorf Düsseldorf Germany

   Department of Trauma Surgery and Orthopaedics, University Hospital Düsseldorf, Düsseldorf, Germany