Surgery effective for elbow instability in female athletes

Seventeen of 18 athletes returned to sports after an average 2.5 months follow-up.

VANCOUVER, British Columbia — Surgical repair or reconstruction can be effective in female athletes with ulnar collateral ligament injuries, according to a study presented here.

Over 3 million females compete annually in high school and college athletics in the United States, and the intensity of competition has dramatically increased over the last several years. Although the female ACL has been extensively studied, little data exists on the surgical treatment of elbow instability in females, according to David B. Argo, MD, lead author of the study.

Argo and colleagues at the Mississippi Sports Medicine and Orthopaedic Center, Jackson, Miss., conducted a retrospective study evaluating surgery for ulnar collateral ligament injuries in females. The study included 19 patients with a mean age of 22 years — 18 athletes and one patient involved in a motor vehicle collision.

Argo presented the results at the Arthroscopy Association of North America 24th Annual Meeting.

Patients underwent surgery if they had symptomatic injuries and medial elbow instability that did not respond to conservative treatment for least five months. Surgeons also considered surgery if the patient wanted to return to certain activities but could not because of their elbow injury, Argo said.

Surgeons first performed a thorough arthroscopic examination and debrided any loose bodies as needed. Surgical repair involved suture anchors in 10 patients, drill holes in one, posterior lateral reconstruction in five, flexor pronator fascia augmentation in one and palmaris graft reconstruction in one, Argo said.

The researchers followed the patients for a mean of 38.8 months. Following surgery, the mean Andrews and Carson Elbow Outcome Score significantly increased to 191 from a preoperative mean of 120 (P=.0001), according to the study.

Overall, 16 patients had excellent results and three patients had good results postoperatively. Additionally, 17 of the 18 athletes returned to sports at an average 2.5 months postop, Argo said.

“The one athlete that did not return to sports was a recreational snow skier who had such a terrible fall she said she never wanted to ski again,” he said.

“Our results indicate that if you have a patient that has medial ulnar collateral ligament instability and is a female that fails conservative treatment, then operative intervention does work,” he added.

For more information:
Argo DB, Trenhaile SW, Savoie FH, Field LD. Operative treatment of ulnar collateral ligament injuries of the elbow in females. #33. Presented at the Arthroscopy Association of North America 24th Annual Meeting. May12-15, 2005. Vancouver, British Columbia.