UCL repair with internal bracing may yield faster return to sport vs. Tommy John surgery
Key takeaways:
- UCL repair with internal bracing yielded faster return to practice and faster return to competition vs. UCL reconstruction.
- Both UCL repair and reconstruction had high rates of return to sport.
Published results showed competitive athletes who underwent ulnar collateral ligament repair with internal bracing had similar patient-reported outcomes and faster return to sport vs. athletes who underwent UCL reconstruction.
“In light of the increasing rate of UCL injuries in overhead athletes, this emphasizes the urgency for optimized surgical interventions tailored to an athlete’s unique needs,” Jeffrey R. Dugas, MD, and colleagues from the American Sports Medicine Institute wrote in the study.
Dugas and colleagues performed a cohort study of data from 461 competitive athletes (mean age, 19.1 years) who underwent surgery for a UCL injury between June 2013 and May 2021. The final cohorts included 268 athletes who underwent UCL repair with internal bracing (follow-up, 4.4 years), 155 athletes who underwent UCL reconstruction (follow-up, 6.3 years) and 38 athletes who required subsequent revision surgery.
Outcome measures included return to sport (RTS), American Shoulder and Elbow Surgeons Elbow assessment form (ASES-E), Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow (KJOC) scores and Andrews-Carson scores.
After controlling for follow-up time, Dugas and colleagues found athletes who underwent UCL repair with internal bracing and athletes who underwent UCL reconstruction had similar postoperative ASES-E, KJOC and Andrews-Carson scores. They found similar percentages of the repair group (9%) and the reconstruction group (8%) required subsequent revision surgery.
Among the 247 athletes in the repair group who attempted to RTS and had complete follow-up, 98% (n = 241) were able to successfully RTS. Among the 147 athletes in the reconstruction group who attempted to RTS and had complete follow-up, 99% (n = 145) were able to successfully RTS.
Dugas and colleagues noted overall RTS rates were not significantly different between the groups. However, they noted the repair group had faster return to practice (6.7 months vs. 10.2 months) and faster return to competition (9.2 months vs. 13.4 months) compared with the reconstruction group.
“UCL repair with internal brace augmentation shows significant promise, yielding results comparable to the established UCL reconstruction in terms of RTS success, [patient-reported outcomes] PROs and complication/reoperation rates,” Dugas and colleagues concluded.
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