This is a cadaveric study similar to the previous review addressing the effectiveness of a single-stranded medial collateral ligament reconstruction in restoring elbow stability. The authors used 11 fresh frozen upper extremities and sequentially transected the medial stabilizers of the elbow. Next, they performed a single-stranded reconstruction of the medial collateral ligament using the extensor carpi radialis brevis tendon harvested through the midline of the wrist. The authors were able to reconstruct the anterior bundle of the medial collateral ligament based on the previous footprint of the transected ligament. Specimens were tested with varus-valgus stress and in conditions of pronation and supination. The results demonstrated that reconstruction of the central portion of the anterior band of the medial collateral ligament restored the stability in the varus-valgus plane. In addition, there was no difference between pronation and supination after reconstruction. The authors note that this technique is simpler than the previous technique through drilled holes in the ulna. They further note that following reconstruction, the position of pronation/supination does not affect stability.
This study again clarifies the importance of correct graft position in collateral ligament reconstruction, which appears to be more important than the number of graft limbs crossing the repair. While the author’s technique may prove easier, the technical feasibility in a chronic situation is unable to be addressed in this cadaveric study.
Journal of Shoulder and Elbow Surgery