Elbow ulnar collateral ligament repair: a systematic review of trends and outcomes.

Background: Ulnar collateral ligament (UCL) injuries of the elbow have rapidly risen among high-level baseball players. These injuries have led to the rise of the UCL repair for partial tears. This technique has been theorized to allow for an earlier return to sport. This review aims to evaluate the current literature regarding UCL repair to help guide surgeons in managing UCL injuries. Methods: A search was conducted across MEDLINE/PubMed, Cochrane, and Embase databases to evaluate for UCL repair. The search used a combination of keywords and Medical Subject Heading terms. Titles and abstracts were screened for eligibility for inclusion criteria. Full texts were screened and included if they met eligibility criteria. Demographics and results of the studies were extracted from the articles that met inclusion criteria. Results: Thirteen relevant studies were found and included in this scoping review. Five studies found that the incidence of UCL repair surgery has increased in recent years. One study found that the incidence of UCL repair surgery increased at a 5.4% faster rate than UCL reconstruction surgery. Repair with suture augmentation was used as the UCL repair technique in four studies. UCL repair showed a return to sport of 86.7% or higher in studies that evaluated return to sport. Four studies reported return to sport at same level or higher, with four studies not specifying return to sport level or return to sport metrics. The most common complication reported was postoperative ulnar nerve neuropathy or paresthesias. Overall, there was a low rate of return to the operating room for complications. Conclusion: This scoping review found that UCL repair surgery continues to rise in popularity. It also found that UCL repair is safe and effective, with patients having low complication rates and high rates of return to sport.