AANA Elbow Arthroscopy - August 2024-UCL RECONSTRUCTION TECHNIQUE_ SURGICAL PEARLS, GRAFT SELECTION AND AUGMENTATION INDICATIONS

UCL RECONSTRUCTION TECHNIQUE_ SURGICAL PEARLS, GRAFT SELECTION AND AUGMENTATION INDICATIONS

Video Transcription

Video Summary

This presentation reviews the evolution and current state of Tommy John surgery, celebrating its 50th anniversary. Despite past success, rising pitching velocities and increased spin rates on pitches have led to higher failure and revision rates post-surgery, especially in elite and youth athletes. The speaker details advanced surgical techniques, including the internal brace repair and a hybrid reconstruction combining repair with tendon grafting. Imaging advancements like the stress MRI “fever view” help better assess ligament integrity. The internal brace method involves minimal implants, preserving native tissue for enhanced healing. Hybrid reconstruction, introduced in 2018, addresses complex cases with high demands, showing promising outcomes in return-to-play rates among professionals and young athletes. Postoperative protocols are velocity-based, with gradual throwing milestones up to a year post-surgery. Complications are rare but include nerve issues and one unusual distal humeral fracture. The presentation underscores ongoing challenges due to pitching evolution, emphasizing the need for improved surgical solutions amid a growing injury epidemic.

Keywords

Tommy John surgery

pitching velocity

internal brace repair

hybrid reconstruction

stress MRI

postoperative protocols