Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Apr 18, 2016; 7(4): 229-243
Published online Apr 18, 2016. doi: 10.5312/wjo.v7.i4.229
Elbow ulnar collateral ligament injuries in athletes: Can we improve our outcomes?
Lauren H Redler, Ryan M Degen, Lucas S McDonald, David W Altchek, Joshua S Dines
Lauren H Redler, Ryan M Degen, Lucas S McDonald, David W Altchek, Joshua S Dines, Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, NY 10021, United States
Author contributions: All authors equally contributed to this paper with conception and design of the study, literature review and analysis, drafting and critical revision and editing, and final approval of the final version.
Conflict-of-interest statement: No potential conflicts of interest. No financial support.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Lauren H Redler, MD, Sports Medicine and Shoulder Service, Hospital for Special Surgery, 535 E 70th St, New York, NY 10021, United States.
Telephone: +1-203-5439376
Received: September 29, 2015
Peer-review started: October 7, 2015
First decision: November 4, 2015
Revised: November 18, 2015
Accepted: January 5, 2016
Article in press: January 7, 2016
Published online: April 18, 2016

Injury to the ulnar collateral ligament (UCL) most commonly occurs in the overhead throwing athlete. Knowledge surrounding UCL injury pathomechanics continues to improve, leading to better preventative treatment strategies and rehabilitation programs. Conservative treatment strategies for partial injuries, improved operative techniques for reconstruction in complete tears, adjunctive treatments, as well as structured sport specific rehabilitation programs including resistive exercises for the entire upper extremity kinetic chain are all important factors in allowing for a return to throwing in competitive environments. In this review, we explore each of these factors and provide recommendations based on the available literature to improve outcomes in UCL injuries in athletes.

Keywords: Elbow, Ulnar collateral ligament, Valgus instability, Tommy John surgery, Rehabilitation, Overhead athlete, Improved outcomes

Core tip: While surgical techniques undoubtedly affect the outcome following ulnar collateral ligament (UCL) reconstruction, they do not independently do so. Rather, it is a complex milieu of pre-operative, intra-operative, and post-operative factors that combine to affect the overall outcome following UCL injury. Due to the variability in success rates for treatment of these injuries, careful review of each of these factors is required to ensure outcomes are optimized following treatment. This study serves as a review of these factors, providing recommendations based on available literature to improve outcomes following UCL injuries in athletes in future years.