In a groundbreaking study that could reshape the treatment landscape for ulnar collateral ligament (UCL) injuries, researchers have found that UCL repair with internal bracing offers a significantly faster return to athletic activity compared to traditional Tommy John surgery, while maintaining equivalent success rates.
The research, conducted at the American Sports Medicine Institute, analyzed data from 461 competitive athletes with a mean age of 19.1 years who underwent UCL surgery between June 2013 and May 2021. The study compared 268 athletes who received UCL repair with internal bracing against 155 who underwent traditional UCL reconstruction.
Accelerated Return to Sport
The most striking finding was the marked difference in recovery timelines. Athletes who underwent UCL repair with internal bracing returned to practice in 6.7 months, compared to 10.2 months for reconstruction patients. More importantly, they resumed competition in 9.2 months, versus 13.4 months for the reconstruction group.
"In light of the increasing rate of UCL injuries in overhead athletes, this emphasizes the urgency for optimized surgical interventions tailored to an athlete's unique needs," noted Dr. Jeffrey R. Dugas and his research team.
Comparable Outcomes and Safety Profile
The study demonstrated that both procedures achieved excellent outcomes. The UCL repair group showed a 98% successful return-to-sport rate (241 of 247 athletes), while the reconstruction group achieved a 99% success rate (145 of 147 athletes).
Patient-reported outcomes, measured using the American Shoulder and Elbow Surgeons Elbow assessment (ASES-E), Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow (KJOC) scores, and Andrews-Carson scores, were similar between both groups after controlling for follow-up time.
Long-term Reliability
The durability of both procedures proved comparable, with revision surgery rates of 9% for the repair group and 8% for the reconstruction group. The study tracked patients for an average of 4.4 years in the repair group and 6.3 years in the reconstruction group, providing robust long-term data.
These findings suggest that UCL repair with internal bracing could offer a compelling alternative to traditional Tommy John surgery, particularly for athletes seeking a faster return to competition without compromising on outcomes.
