We’re going to continue our discussion with Dr. Michael Ciccotti and dive deeper into UCL surgery, including surgical techniques and outcomes for both primary and revision UCL reconstruction.

We’ll start with the systematic review and meta-analysis titled Modified Jobe Versus Docking Technique for Elbow Ulnar Collateral Ligament Reconstruction. Chang and his colleagues found no significant difference in clinical outcomes and return to sport between the docking or figure-of-8 technique once controlled for surgical approach. It appears that inferior outcomes attributed to the original figure-of-8 technique may be more related to detachment of the flexor pronator mass during the approach and submuscular ulnar nerve transposition.

Then from the November 2020 issue of AJSM, we review the publication Ulnar Collateral Ligament Tear Location May Affect Return-to-Sports Rate but Not Performance Upon Return to Sports After Ulnar Collateral Ligament Reconstruction Surgery in Professional Baseball Players. Dave Altchek and team at HSS reported that professional baseball players who sustained a distal UCL tear were more likely to return to sport after UCL reconstruction compared to players that had a proximal UCL tear..

Lastly, Andrews and his team published a study on Outcomes After Ulnar Collateral Ligament Revision Reconstruction in Baseball Players. The authors found that outcomes after revision UCL reconstruction are not as favorable as those after primary reconstruction, with only half of all baseball players returning to their previous level of play after revision reconstruction.