Variability of rehabilitation protocols for ulnar collateral ligament repair with suture tape augmentation

Background

The ulnar collateral ligament (UCL) is frequently injured in overhead throwing athletes, leading to elbow instability, pain and decreased performance, and requiring surgical intervention. Augmenting with suture tape provides a novel approach to UCL repair, offering stability while preserving native anatomy, proprioception, and minimizing bone loss, with the added benefit of an expected faster rehabilitation and return to sport (RTS) compared to traditional UCL reconstruction. The purpose of this study is to assess the variability of the current publicly available rehabilitation protocols for elbow UCL repair with suture tape augmentation.

Methods

A systematic review of Google and PubMed was performed to find rehabilitation protocols for UCL repair with suture tape augmentation. Two hundred nine orthopedic surgery residency programs were identified using the Fellowship and Residency Electronic Interactive Database Access. The programs were searched on Google, a broad nonspecific Google search, and a systematic literature search of journal databases for UCL repair with suture tape augmentation rehabilitation protocols was conducted.

Results

Thirteen rehabilitation protocols met the inclusion criteria for analysis. Of these, 12 protocols outlined the use of an articulating brace at varying range of motion settings for the first 4-6 weeks following surgery. Return to throwing was included in all 13 protocols and began between 10 and 12 weeks following surgery. RTS was included in 11 protocols and expected athletes competing as early as 16 weeks with a mean recommended RTS at 21.5 weeks.

Conclusion

Rehabilitation protocols for UCL repair with suture tape augmentation were often structured around a 5-phase program with RTS approaching 20 weeks. They utilized immobilization and range of motion restriction as well as strengthening and gradual RTS procedures. Overall, the included protocols had mild variability with initiation of throwing and RTS 12 to 24 weeks faster than traditional UCL reconstruction.