Patients › Elbow

Elbow Ligament Reconstruction (Stabilisation)

Updated Sep 2026

Why this operation has been suggested¶

Dr Kieran Hirpara, an upper-limb surgeon at Mater Private Hospital Rockhampton, matches the treatment to your specific injury. Patients are generally referred to our clinic by their GP; if a physiotherapist has suggested you see us, you will still need a referral from your GP in order to be eligible for the Medicare rebate. At your appointment we take a history, examine your elbow, and arrange scans if they are needed to work out what is wrong.

Elbow ligament reconstruction is an operation that rebuilds a worn or torn ligament with a piece of donor tendon, holding the joint steady. We usually suggest it when your elbow still feels like it is giving way, or will not stay in place, after other treatment has not given enough improvement. It is also offered when the elbow can only be kept in joint by holding it nearly straight, or when a fracture around the joint has left it unstable. The aim is a stable elbow you can move, use, and rely on without pain. Allograft reconstruction restores elbow stability in approximately 85% of the elbows with posterolateral rotatory instability. We will talk this through with you and decide together whether it suits your elbow and your goals.

Before the operation¶

In the weeks before surgery we finish planning with scans such as an X-ray, MRI (a scan that shows soft tissues like ligaments), or ultrasound. On the day, stop eating and drinking seven hours beforehand. We ask for seven hours so your operation can be brought forward if the theatre list runs early; your surgeon will confirm your exact fasting time. You may need to pause some medications before surgery, and we will give you clear instructions about which ones and for how long. Bring a written list of everything you take, including tablets, drops and creams. Arrange for someone to drive you home afterwards. Wear loose, comfortable clothing with sleeves that slide over your elbow. If you have other medical conditions, you may also need blood tests or a review with the anaesthetist (the doctor who gives the anaesthetic).

On the day¶

You arrive at the hospital's surgical admissions unit, where you are checked in and prepared for theatre. You will meet the anaesthetist there. This operation is done under general anaesthetic. A regional nerve block is sometimes added for post-operative pain relief; the anaesthetist will discuss this with you on the day. You are then taken into the operating theatre, where the operation is performed. When it is finished, you wake up in the recovery area, where nurses monitor you while the anaesthetic wears off. Once you are stable, you either go to the ward or go home, depending on the procedure and your recovery.

The aim of the day is simple: restore enough stability to your elbow so it can start moving soon after surgery. Keeping the elbow still for a long time afterwards tends to make it stiff, so early movement is part of the plan.

What the operation involves¶

The exact steps depend on which structures around your elbow are injured, and we plan this from your scans before the day. If a fracture is part of the problem, your surgeon fixes the broken pieces of bone first, using screws or a small plate. If a broken piece of bone at the top of the forearm cannot be repaired, it may be replaced with a metal implant. Once the bone is secure, the torn ligaments are repaired or rebuilt.

Rebuilding a ligament means making a new one from a piece of tendon. This may come from donor tissue, or from your own body. Small anchors hold the new ligament to the bone in the right places, and your surgeon checks that the elbow stays in joint through its whole range of movement before finishing. Sometimes a sturdy suture tape is added alongside the repair to act like an internal brace, supporting the ligament while it heals. If the elbow still will not hold itself steady, a temporary hinge may be fitted to keep it in place while things settle.

The operation can often be done through small cuts rather than one long opening. For some ligament rebuilds, a cut of about 2 to 3 cm is enough. Working through small cuts protects the healthy tendons and muscle around the joint, and avoids disturbing the joint lining itself.

When the repair is complete, the cuts are closed with stitches and covered with a dressing. The goal of the whole operation is a stable elbow that can start moving soon afterwards, because keeping it still for too long tends to leave it stiff.

After the operation¶

You will wake up in the recovery area, where nurses keep a close eye on you while the anaesthetic wears off. Your arm will be in a sling or supported on pillows, with a dressing over the wounds. We will give you pain relief and check that it is working before you move around. Someone should stay with you for the first 24 hours after you go home. Your team will tell you whether you go home the same day or stay one night in hospital. We leave the dressing on for about 10 days; please do not take it off before then unless we tell you to. We change or remove it when we see you. Most people can walk around and do light tasks straight away, but keep your elbow resting in the sling when you are up and about.

Recovery¶

For the first few days your elbow will be sore and swollen. This settles gradually. Rest, keeping your arm raised, and the pain relief we give you will ease the discomfort. Some aching when you first start moving the joint is normal and improves as the weeks pass.

You will go home with your arm in a sling. You can walk around and do light tasks straight away, but keep your elbow resting in the sling when you are up and about. Your hand and wrist can move early, and gentle exercises for them usually begin within days. Hand therapy after surgery is with Ruby Doolan at Extend Rehabilitation. Ruby is a hand therapist: she will guide your exercises and make any splint you need. The aim of therapy is steady, early movement, because keeping the elbow still for too long tends to leave it stiff.

As the swelling settles, you will use your arm more: eating, writing, and light household tasks. Once your surgeon is happy the repair is secure, the sling comes off and you begin bending and straightening the elbow itself. Movement often improves quickly at first, then more slowly. When you can grip and hold objects without pain, everyday activities feel easier. Driving is not safe while your arm is in a sling, and you will need to be able to hold the wheel with both hands and react in an emergency stop, off strong pain medication. Our guide to driving after upper-limb surgery explains when you can return.

Everyone heals at their own pace. Your timeline may differ, and your surgeon and therapist will guide you along the way.

What can go wrong¶

Most patients do well, but problems can occasionally happen. Your surgeon and the team monitor you closely to spot any issue early.

The nerve that runs along the inside of your elbow can become irritated after surgery. You might notice tingling, pins and needles, or numbness in your ring and little fingers. Often this settles on its own, but tell us if it does not ease, or if the fingers feel weak.

The elbow can sometimes stay loose or feel like it is giving way again. If your elbow starts to feel unsteady, or slips out of place, contact the clinic straight away.

The elbow can also become stiff. You may find it hard to straighten or bend the arm fully, and the movement may feel blocked rather than sore. Bring this up at your review, as extra therapy or further treatment can help.

Infection is uncommon but serious. Watch for a deep, throbbing pain that does not ease with simple painkillers, redness spreading out from the wound, or fluid leaking from it. If you notice these, call the clinic the same day, or go to the emergency department if you feel feverish or unwell.

The small metal anchors or screws used to hold the repair can sometimes cause irritation, or a temporary hinge may loosen. You might feel a new clicking, catching, or a lump under the skin. Mention it at your next review.

Where a piece of your own tendon is used to rebuild the ligament, that spot can stay tender or achy for a while. Let us know if it worsens rather than improves.

Bone can sometimes form where it should not, around the joint or inside it. This can limit movement or cause catching and grinding. If your elbow stops progressing, raise it at your review.

The scar itself can occasionally break down or weep. If the wound opens, becomes redder, or starts to discharge, contact us rather than waiting.

The complications table on this page lists typical rates if you want the specifics.

When to call us¶

Most problems show up early, and we would rather hear about them sooner than later. Call us if you have a fever, if the wound becomes redder or starts leaking fluid, or if your pain keeps getting worse instead of easing. Go to emergency if you have swelling or pain in your calf, or sudden shortness of breath. Call us straight away if your ring and little fingers go numb, if your hand feels weak, or if you cannot move your arm at all. If your elbow slips out of place or feels like it is giving way again, contact the clinic the same day.

Evidence & references

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Overview¶

An all-arthroscopic technique for reconstruction of the lateral ulnar collateral ligament (LUCL) is reproducible and avoids residual instability [1].
Open posterolateral ligament plication and LUCL repair using an all-suture construct allows for complete posterolateral stabilization of the elbow with a single implant and bone preservation [2].
A suture-augmented LUCL and radial collateral ligament reconstruction method provides a reproducible, anatomically based construct that restores posterolateral elbow stability [3].
The suture-augmented LUCL and radial collateral ligament reconstruction method addresses the complex spectrum of lateral-sided injuries observed in posterolateral rotatory instability (PLRI) [3].
An arthroscopic LUCL plication/reconstruction with augmented lateral collateral ligament imbrication is a minimally invasive method that allows effective management of elbow instability [4].
The arthroscopic LUCL plication/reconstruction with augmented lateral collateral ligament imbrication promotes quicker patient recovery and long-term functional restoration [4].
The use of suture button fixation for repair of the lateral ulnar collateral ligament in terrible triad injuries has not been previously described [5].
Reconstruction of the lateral ulnar collateral ligament with a tendon graft offers an alternative that restores stability through a dynamic “sling effect” rather than rigid constraint [6].

Anatomy & Pathophysiology¶

Bony Anatomy¶

The elbow is a trocho-ginglymoid joint consisting of medial and lateral articulations that provide bony stability [11].
The trochlea articulates with the ulna within the greater sigmoid notch to create the ulnohumeral, hinged, or trochoid portion of the elbow joint [11].
The ulnohumeral articulation has highly congruent anatomy through almost 180° of articular contact, except for the bare area of the greater sigmoid notch which is devoid of cartilage [11].
The coronoid has a medial and lateral facet which buttresses the trochlea anteriorly [11].
The sublime tubercle is located just distal and medial to the coronoid and provides the attachment site for the anterior bundle of the medial ulnar collateral ligament [11].
The medial epicondyle forms the attachment site for the origins of the flexor pronator mass and is larger and more posteriorly oriented than the lateral epicondyle [11].
The capitellum and radial head form the radiocapitellar joint [11].
The radius is held in close approximation to the ulna at the proximal radioulnar joint by the annular ligament [11].
The area of the ulna which articulates with the margin of the radial head at the proximal radioulnar joint is known as the lesser sigmoid notch [11].
The radial head is a concave elliptical structure covered with articular cartilage along the radiocapitellar joint and approximately 270° of the articular margin [11].
The radial head articulates with both the capitellum and the lesser sigmoid notch [11].
The lateral epicondyle is the origin of the lateral extensor musculature [11].
The origin of the lateral ulnar collateral ligamentous complex is located just distal to the lateral epicondyle at the geometric center of the radiocapitellar articulation [11].
The distal humeral articulation is angled 30° from the longitudinal axis [11].
The anterior humeral line should pass through the center of the axis of rotation [11].
The axis of rotation is 5° to 7° angulated in the coronal plane to the epicondylar axis, with the medial side more distal than the lateral side [11].
The angulation of the distal humeral articulation accounts for the change from a valgus carrying angle to a more varus position as the elbow is flexed [11].
There is a high correlation between the size of the radius and capitellum on the left and right sides in the same individual [11].
The olecranon allows for a broad attachment site of the triceps [11].
The ulna medially bends approximately 8° at 8 cm from the tip of the olecranon [11].
The articulation to the tip of the coronoid is approximately 30° from the long axis of the ulna in the sagittal plane [11].
The radial head should line up with the capitellum at all arm positions on all radiographic views [12, 13].
Tensile forces are present at the medial elbow and compressive forces are present at the lateral elbow [12, 13].

Ligaments & Stability¶

Elbow stability is conferred by bony articular anatomy and ligamentous structures on the medial and lateral sides [9].
The three primary stabilizers of the elbow are the ulnohumeral articulation, the medial ulnar collateral ligament, and the lateral ulnar collateral ligament complex [9].
Secondary stabilizers of the elbow include the radiocapitellar articulation, the common flexor tendon, the common extensor tendon, and the joint capsule [9].
The lateral ulnar collateral ligament is the posterolateral stabilizer of the elbow [12, 13].
The medial or ulnar collateral ligament is the primary valgus stabilizer of the elbow [12, 13].
The anterior bundle of the medial ulnar collateral ligament is the most important component for stability [12, 13].
The posterior bundle of the medial ulnar collateral ligament has the greatest change in length and becomes taut at flexion beyond 120 degrees [12, 13].
The lateral ulnar collateral ligament arises from the epicondyle and inserts on the annular ligament [18].
A separate band of the lateral ligamentous complex, the lateral ulnar collateral ligament, arises at the lateral epicondyle and blends with fibers of the annular ligament before inserting on the tubercle on the crest of the supinator of the ulna [18].
The lateral ulnar collateral ligament is described as the main lateral stabilizer, taut in flexion and extension [18].
Disruption of the lateral ulnar collateral ligament results in posterolateral rotatory instability [18].
The lateral collateral ligament contributes 14% of the varus stability of the elbow with the joint in full extension [18].
The lateral collateral ligament contributes 9% of the varus stability of the elbow with the joint in 90 degrees of flexion [18].
The remainder of varus stability is contributed by the bony articular surfaces and the anterior capsule, with the bony surfaces providing the stability [18].
The ulnar collateral ligament plays an important role in valgus stability [18].
Valgus stability is divided equally among the ulnar collateral ligament, the anterior capsule, and the bony articulation with the elbow in full extension [18].
At 90 degrees of flexion, the ulnar collateral ligament provides 55% of the stability to valgus stress [18].
The anterior bundle of the ulnar collateral ligament is the primary stabilizer for valgus stress at 90 degrees of flexion [18].
The primary stabilizers of the elbow are the anterior band of the medial ulnar collateral ligament and the lateral collateral ligament complex, consisting of the lateral collateral ligament, annular ligament, and the lateral ulnar collateral ligament [18].
Secondary stabilizers consist of the capsule, the ulnohumeral and radiocapitellar articulations, and dynamic stabilizers consisting of all muscle-tendon units that cross the elbow joint [18].
Dynamic stabilizers include the biceps, brachialis, triceps, wrist flexors, and wrist extensors [18].
Insufficiency of one or more stabilizers may result in a spectrum of instability from subtle valgus or posterolateral rotatory instability to recurrent dislocation [18].
The typical injury pattern for traumatic elbow dislocation involves a fall on a slightly flexed extremity with a valgus internal rotation force of the forearm [18].
In traumatic elbow dislocation, structures are disrupted on the lateral side, progressing medially as more force is applied [18].
When recurrence or persistence in instability results from traumatic dislocation, the posterolateral structures are most commonly affected [18].
Medial structures can also be involved in traumatic dislocation and cause significant instability [18].
A coronoid fracture in association with disruption of the posterior band of the ulnar collateral ligament can result in symptomatic posteromedial instability [18].
Isolated medial side disruptions from valgus stress can result from football tackling, gymnastics, or throwing a javelin [18].
Valgus instability from attritional disruption of the anterior bundle of the medial ulnar collateral ligament is the most common form of recurrent elbow instability [18].
The anterior bundle of the medial ulnar collateral ligament is divided into two nonisometric bands: an anterior band taut at 0 to 60 degrees and a posterior band taut at 60 to 120 degrees [18].
During the acceleration phase of throwing, up to 60 N of force is applied to the medial ulnar collateral ligament, which is near its tensile failure point [18].
Pitcher fatigue, poor mechanics, or repetition overuse can result in bundle fiber failure, partial tearing, and eventual complete disruption of the medial ulnar collateral ligament [18].
Failure of the primary stabilizer results in increased stress on secondary stabilizers [18].
Increased stress on secondary stabilizers can result in capsular contractures, chondromalacia, osteophytes, and loose bodies from compression of the radiocapitellar joint and shear forces to the posteromedial tip of the olecranon [18].
Ulnar nerve symptoms may develop from traction, scarring, or osteophyte impingement following primary stabilizer failure [18].

Muscles & Soft Tissue¶

The brachialis is the strongest elbow flexor and attaches to the coronoid 11 mm distal to the tip [12, 13].
The biceps brachii inserts at the ulnar margin of the radial tuberosity, with the long head proximal and short head distal [12, 13].
The biceps brachii is a powerful supinator of the forearm [12, 13].
The primary elbow extensor, the triceps, inserts on the olecranon process [12, 13].
The mobile wad consists of the brachioradialis, extensor carpi radialis longus, and extensor carpi radialis brevis [12, 13].
The flexor-pronator mass consists of the pronator teres, flexor carpi radialis, palmaris longus, flexor carpi ulnaris, and flexor digitorum superficialis [12, 13].
The common origin of the extensor muscles is attached to the lateral condyle and need not be disturbed in a lateral approach to a fracture of the lateral condyle [14].
The radial nerve enters the interval between the brachialis and brachioradialis muscles in the proximal angle of the lateral approach wound [14].
The deep branch of the radial nerve enters the supinator muscle and must be protected during lateral approach dissection [14].
The common extensor tendon is a secondary stabilizer of the lateral elbow [8].
The articular capsule is a secondary stabilizer of the lateral elbow [8].

Pathophysiology & Instability¶

Elbow instability may be congenital, traumatic, or attritional [18].
In a long-term follow-up study of simple elbow dislocations, 60% of patients had residual stiffness with loss of extension and residual pain [18].
In a long-term follow-up study of simple elbow dislocations, only 8% of patients had functional instability [18].
When fractures are associated with elbow dislocation, resulting in loss of bony stability provided by the greater sigmoid notch of the ulna or the radiocapitellar joint, greater instability and disability can be anticipated [18].
The docking technique for lateral ulnar collateral ligament reconstruction has shown recurrent instability rates as high as 25% [8].
Postoperative stiffness is a known complication of lateral ulnar collateral ligament reconstruction and occurs not uncommonly [8].

Classification¶

The docking technique originally described by Jones et al. in 2012 is the most common method in use in contemporary practice for LUCL reconstruction [8].
The docking technique has shown recurrent instability rates as high as 25% [8].
A knotless, onlay technique performs LUCL reconstruction with a tendon graft without violation of the extensor origin and soft tissue envelop [8].
The use of knotless anchors and an onlay technique shortens operative time, reduces the required surgical exposure, and removes the risk of tunnel osteolysis or fracture and resultant graft failure while maintaining a broad bone surface for graft incorporation [8].
Minimally-invasive dissection prevents iatrogenic injury to the common extensor origin, an important secondary stabilizer of the lateral elbow, and the articular capsule [8].
Remaining extracapsular with a minimally-invasive technique avoids plication of the capsular structures or risk of formation of intra-articular adhesions, theoretically reducing the risk of any postoperative loss of range of motion [8].

Clinical Presentation¶

Posterolateral rotatory instability of the elbow involves a complex spectrum of lateral-sided injuries [3].
High-grade atraumatic posterolateral rotatory instability is a clinical presentation managed by arthroscopic lateral collateral ligament reconstruction with tendon graft [6].
Subacute and chronic posterolateral rotatory instability is a clinical presentation managed by suture-augmented lateral ulnar collateral ligament and radial collateral ligament reconstruction [3].
Terrible triad injuries are a clinical presentation in which lateral ulnar collateral ligament repair using suture button fixation is indicated [5].

Investigations¶

Physical Examination¶

Elbow stability is determined by primary stabilizers (ulnohumeral articulation, MUCL, LUCL complex) and secondary stabilizers (radiocapitellar articulation, common flexor tendon, common extensor tendon, joint capsule) [9].
The normal elbow has a range of motion from 0° to 140° from extension to flexion and 75° and 85° in pronation and supination respectively [9].
A functional arc in each plane is 100° for flexion and extension and forearm rotation [9].
The physical exam is directed by history and the location of the patient's pain in the anterior, posterior, medial, or lateral aspect of the elbow [9].

Imaging¶

Plain radiographs remain the hallmark and the best screening test for elbow evaluation [9].
AP, lateral, and oblique radiographs are standard for elbow evaluation [17].
CT is helpful when assessing for malunion architecture and the location and pattern of osteophytes and/or loose bodies [17].
Three-dimensional CT is used to check for heterotopic ossification [17].
CT is not necessary when the stiffness is entirely soft-tissue related [17].
MRI can be used to evaluate ligaments and tendons, but it is rarely indicated for elbow stiffness [17].
Magnetic resonance evaluation of the elbow includes imaging of ligament complexes [16].
MR evaluation of instability patterns including the soft-tissue lesions that result from dislocation is emphasized [16].
MRI may be most helpful in evaluating associated injuries including partial or complete tears of the MCL in valgus extension overload syndrome [20].
CT with two-dimensional reconstruction and three-dimensional surface rendering best visualizes the pathology of valgus extension overload syndrome [20].
Radiographic evaluations are essential when diagnosing an OCD lesion of the elbow, however important aspects of the OCD lesions may be better seen with MRI [21].

Treatment¶

Arthroscopic Techniques¶

An all-arthroscopic reconstruction of the lateral ulnar collateral ligament is a reproducible technique that avoids residual instability [1].
Arthroscopic lateral ulnar collateral ligament plication or reconstruction with augmented lateral collateral ligament imbrication is a minimally invasive method that promotes quicker patient recovery and long-term functional restoration [4].
Arthroscopic lateral ulnar collateral ligament reconstruction with a tendon graft restores stability through a dynamic "sling effect" rather than rigid constraint [6].
Arthroscopic-assisted lateral ulnar collateral ligament reconstruction provides less insult and dissection to the soft tissue at the lateral side of the elbow [7].
Arthroscopic-assisted lateral ulnar collateral ligament reconstruction serves as an excellent tool to diagnose concomitant intraarticular pathologies [7].

Open and Mini-Invasive Techniques¶

Open posterolateral ligament plication and lateral ulnar collateral ligament repair using an all-suture construct allows for complete posterolateral stabilization of the elbow with a single implant and bone preservation [2].
Suture-augmented lateral ulnar collateral ligament and radial collateral ligament reconstruction provides a reproducible, anatomically based construct that restores posterolateral elbow stability [3].
Suture-augmented lateral ulnar collateral ligament and radial collateral ligament reconstruction addresses the complex spectrum of lateral-sided injuries observed in posterolateral rotatory instability [3].
A mini-invasive approach for lateral ulnar collateral ligament reconstruction uses a knotless, onlay technique that performs reconstruction without violation of the extensor origin and soft tissue envelop [8].
The knotless, onlay technique for lateral ulnar collateral ligament reconstruction shortens operative time and reduces the required surgical exposure [8].
The knotless, onlay technique for lateral ulnar collateral ligament reconstruction removes the risk of tunnel osteolysis or fracture and resultant graft failure while maintaining a broad bone surface for graft incorporation [8].
Minimally-invasive dissection for lateral ulnar collateral ligament reconstruction prevents iatrogenic injury to the common extensor origin and the articular capsule [8].
Minimally-invasive dissection for lateral ulnar collateral ligament reconstruction allows for earlier rehabilitation and return of range of motion, reduced postoperative pain, and reduced operative time [8].
Fluoroscopic guidance during minimally-invasive lateral ulnar collateral ligament reconstruction can help to reduce injuries to unintended structures [8].
Remaining extracapsular during lateral ulnar collateral ligament reconstruction avoids plication of the capsular structures and the risk of formation of intra-articular adhesions [8].
Remaining extracapsular during lateral ulnar collateral ligament reconstruction theoretically reduces the risk of postoperative loss of range of motion [8].

Specific Indications and Constructs¶

Suture button fixation for repair of the lateral ulnar collateral ligament in terrible triad injuries has not been previously described [5].

Complications¶

The docking technique for LUCL reconstruction has shown recurrent instability rates as high as 25% [8].
Postoperative stiffness is a known complication of LUCL reconstruction and occurs not uncommonly [8].
The use of a knotless, onlay technique removes the risk of tunnel osteolysis or fracture and resultant graft failure [8].
Minimally-invasive dissection prevents iatrogenic injury to the common extensor origin, an important secondary stabilizer of the lateral elbow [8].
Minimally-invasive dissection prevents iatrogenic injury to the articular capsule [8].
Remaining extracapsular with a minimally-invasive technique avoids plication of the capsular structures [8].
Remaining extracapsular with a minimally-invasive technique avoids the risk of formation of intra-articular adhesions [8].
Fluoroscopic guidance can help to reduce injuries to unintended structures that could be foreseen due to a limited exposure [8].

Recovery¶

The arthroscopic reconstruction of the lateral ulnar collateral ligament avoids residual instability [1].
The open posterolateral ligament plication and lateral ulnar collateral ligament repair technique allows for complete posterolateral stabilization of the elbow [2].
The open posterolateral ligament plication and lateral ulnar collateral ligament repair technique achieves bone preservation [2].
The suture-augmented lateral ulnar collateral ligament and radial collateral ligament reconstruction restores posterolateral elbow stability [3].
The arthroscopic lateral ulnar collateral ligament plication/reconstruction with augmented lateral collateral ligament imbrication promotes quicker patient recovery [4].
The arthroscopic lateral ulnar collateral ligament plication/reconstruction with augmented lateral collateral ligament imbrication promotes long-term functional restoration [4].
Reconstruction of the lateral ulnar collateral ligament with a tendon graft restores stability through a dynamic “sling effect” rather than rigid constraint [6].

Key Evidence¶

[L5] The presented arthroscopic technique is reproducible and achieves the reconstruction of the LUCL of the elbow as well as avoids residual instability. [1] (10.1016/j.eats.2024.103096)
[L5] The technique allows for complete posterolateral stabilization of the elbow with a single implant and bone preservation. [2] (10.1016/j.eats.2024.103172)
[L5] The described method provides a reproducible, anatomically based construct that restores posterolateral elbow stability and addresses the complex spectrum of lateral-sided injuries observed in PLRI. [3] (10.1016/j.eats.2025.103797)
[L5] This minimally invasive method allows effective management of elbow instability while promoting quicker patient recovery and long-term functional restoration. [4] (10.1016/j.eats.2025.103529)
[L4] The use of suture button fixation for repair of lateral ulnar collateral ligament has not been previously described. [5] (10.1016/j.eats.2023.10.004)
[L5] Reconstruction of the lateral ulnar collateral ligament with a tendon graft offers an alternative, restoring stability through a dynamic “sling effect” rather than rigid constraint. [6] (10.1002/atn2.70037)
[L5] It provides less insult and dissection to the soft tissue at the lateral side of the elbow while being an excellent tool to diagnose any concomitant intraarticular pathologies. [7] (10.1016/j.eats.2024.103101)
[L5] [8] (10.1002/atn2.70135)

References¶

[1] Posterolateral Elbow Dislocation: An All‐Arthroscopic Reconstruction of the Lateral Ulnar Collateral Ligament. Arthroscopy Techniques. 2024. DOI: 10.1016/j.eats.2024.103096

[2] Open Posterolateral Ligament Plication and Lateral Ulnar Collateral Ligament Repair in Posterolateral Rotatory Instability of the Elbow Using an All‐Suture Construct. Arthroscopy Techniques. 2024. DOI: 10.1016/j.eats.2024.103172

[3] Suture‐Augmented Lateral Ulnar Collateral Ligament and Radial Collateral Ligament Reconstruction for Subacute and Chronic Posterolateral Rotatory Instability. Arthroscopy Techniques. 2025. DOI: 10.1016/j.eats.2025.103797

[4] Arthroscopic Lateral Ulnar Collateral Ligament Plication/Reconstruction With Augmented Lateral Collateral Ligament Imbrication. Arthroscopy Techniques. 2025. DOI: 10.1016/j.eats.2025.103529

[5] Suture Button Repair for Lateral Ulnar Collateral Ligament in Terrible Triad Injuries: Surgical Technique. Arthroscopy Techniques. 2024. DOI: 10.1016/j.eats.2023.10.004

[6] Arthroscopic Lateral Collateral Ligament Reconstruction With Tendon Graft in High‐Grade Atraumatic Posterolateral Rotatory Instability in Elbows. Arthroscopy Techniques. 2026. DOI: 10.1002/atn2.70037

[7] Arthroscopic‐Assisted Lateral Ulnar Collateral Ligament Reconstruction for Posterolateral Rotatory Instability of the Elbow: A Technical Note. Arthroscopy Techniques. 2024. DOI: 10.1016/j.eats.2024.103101

[8] Lateral Ulnar Collateral Ligament Reconstruction Through a Mini‐Invasive Approach. Arthroscopy Techniques. 2026. DOI: 10.1002/atn2.70135

[9] Orthopaedic Knowledge Update 13 Ebook Without Multimedia. Anatomy, Biomechanics, Physical Examination, and Imaging of the Elbow > Summary and Conclusions.

[11] Orthopaedic Knowledge Update 13 Ebook Without Multimedia. Anatomy, Biomechanics, Physical Examination, and Imaging of the Elbow > Anatomy > Bony Anatomy.

[12] Miller S Review Of Orthopaedics. SECTION 16 PATELLAR TRACKING IN TOTAL KNEE ARTHROPLASTY > TABLE 2.3 Shoulder Spaces.

[13] Miller S Review Of Orthopaedics. Genetics of musculoskeletal conditions and abnormalities are summarized in Table 1.27 > TABLE 2.3 Shoulder Spaces.

[14] Campbell S Operative Orthopaedics 4 Volume Set. LATERAL APPROACHES.

[16] Orthopaedic Knowledge Update Sports Medicine 6. Magnetic Resonance Imaging of the Elbow > Annotated References.

[17] Aaos Comprehensive Orthopaedic Review 3. Elbow Stiffness* > IV. Evaluation.

[18] Campbell S Operative Orthopaedics 4 Volume Set. POSTERIOR SURGICAL APPROACH FOR QUADRILATERAL SPACE SYNDROME > MCLAUGHLIN PROCEDURE > ARTHROSCOPIC SURGERY.

[20] Aaos Comprehensive Orthopaedic Review 3. Elbow Injuries in the Athlete* > III. Valgus Extension Overload Syndrome and Posterior Impingement.

[21] Orthopaedic Knowledge Update. Osteochondritis Dissecans of the Knee and Elbow* > Summary.

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