ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2025
Surgical revision after previous failed lateral ulnar collateral ligament (LUCL) reconstruction and persisting posterolateral rotatory instability (PLRI) of the Elbow: a retrospective multicentric analysis.
Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed.
- Anatomic feasibility of using Shark Screw tendon for humeral ligament re-construction in medial and posterolateral elbow instability.JSES international · 2026Article
- Review
- Suture-Augmented Lateral Ulnar Collateral Ligament and Radial Collateral Ligament Reconstruction for Subacute and Chronic Posterolateral Rotatory Instability.Arthroscopy techniques · 2025Article
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7 authors.
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Abstract
purposeThe aim of this study was to identify causes for recurrent PLRI, compare surgical treatment options, and analyze functional outcomes following revision LUCL reconstruction.
methodsA retrospective multicentric case analysis was conducted, including patients who underwent revision LUCL surgery due to recurrent PLRI. Demographic data, surgical techniques (for primary and revision LUCL reconstruction) and postoperative rehabilitation protocols were analyzed, and causes of failure documented. Functional outcomes were assessed using the Patient-Rated Elbow Evaluation (PREE) and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaires.
resultsA total of 37 patients with a mean age of 44.3 years (± 12.3) and a median follow-up of 40.9 months (interquartile range, 20.5-77.0) with revision LUCL surgery were included. Recurrent instability was mainly attributed to graft insufficiency or loosening (59.5%) and rupture of the humeral graft (37.8%). Failure of humeral fixation occurred in 48.7% of cases, often due to loosening or widening of the drill hole. While triceps tendon autografts were most commonly used for primary LUCL reconstruction (89.2%), triceps and hamstring tendon autografts were used in revision procedures (35.1% and 32.4%, respectively). Fixation of the humerus was most commonly performed with tenodesis screws (83.8% in primary procedures and 73.0% in revision procedures), and fixation of the ulnaris was generally performed with biceps buttons in both primary procedures (75.7%) and revision procedures (51.4%). Out of 37 patients, eight complications (21.6%) were reported following revision surgery, including three cases of recurrent instability (8.1%). The median QuickDASH score was 42.5 (IQR, 25.4-80.2), and the median PREE score was 13.0 (IQR, 1.0-41.4).
conclusionRevision LUCL reconstructions remain challenging. The most common causes of failure are graft insufficiency or loosening, and humeral graft rupture, resulting in recurrent PLRI. Additionally, revision LUCL reconstruction is associated with moderate to poor postoperative outcome scores and a relatively high complication rate.
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