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Kinematics of Thumb Ulnar Collateral Ligament Repair With Suture Tape Augmentation

  • Nilay A. Patel
    Affiliations
    Orthopaedic Biomechanics Laboratory, Tibor Rubin VA Long Beach Healthcare System and University of California Irvine, Long Beach, CA
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  • Charles C. Lin
    Affiliations
    Orthopaedic Biomechanics Laboratory, Tibor Rubin VA Long Beach Healthcare System and University of California Irvine, Long Beach, CA

    Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, New York, NY
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  • Yasuo Itami
    Affiliations
    Orthopaedic Biomechanics Laboratory, Tibor Rubin VA Long Beach Healthcare System and University of California Irvine, Long Beach, CA

    Department of Orthopedic Surgery, Osaka Medical College, Takatsuki, Osaka, Japan
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  • Michelle H. McGarry
    Affiliations
    Orthopaedic Biomechanics Laboratory, Tibor Rubin VA Long Beach Healthcare System and University of California Irvine, Long Beach, CA

    Orthopaedic Biomechanics Laboratory, Congress Medical Foundation, Pasadena, CA
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  • Steven S. Shin
    Correspondence
    Corresponding author: Steven S. Shin MD, Cedars-Sinai Kerlan Jobe Institute, 6801 Park Terrace Drive #400, Los Angeles, CA 90045.
    Affiliations
    Cedars-Sinai Kerlan-Jobe Institute, Los Angeles, CA
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  • Thay Q. Lee
    Affiliations
    Orthopaedic Biomechanics Laboratory, Tibor Rubin VA Long Beach Healthcare System and University of California Irvine, Long Beach, CA

    Orthopaedic Biomechanics Laboratory, Congress Medical Foundation, Pasadena, CA
    Search for articles by this author
Published:November 11, 2019DOI:https://doi.org/10.1016/j.jhsa.2019.09.005

      Purpose

      Acute thumb ulnar collateral ligament (UCL) tears are common injuries of the thumb in athletes. Thumb UCL repair with suture tape augmentation is a novel procedure that may allow earlier return to play. The purpose of this study was to evaluate the biomechanical characteristics of the thumb after UCL repair with and without suture tape augmentation.

      Methods

      Eight cadaveric thumbs were tested in a custom hand testing system. Varus–valgus kinematics were measured at –10°, 0°, 15°, and 30° of thumb metacarpophalangeal flexion under the following conditions: (1) intact thumb UCL, (2) complete UCL tear (proper and accessory ligaments), (3) UCL repair, and (4) UCL repair with suture tape augmentation. Angular stiffness was also quantified after application of sequentially increasing valgus torque in the intact UCL repair and the UCL repair with suture tape augmentation conditions.

      Results

      Complete UCL tear increased total varus–valgus angulation at all degrees of thumb metacarpophalangeal flexion. Thumb UCL repair alone and repair with suture tape augmentation decreased total varus–valgus angulation relative to complete UCL tear at all flexion angles. Total varus–valgus angulation was not significantly different from intact results for either the repair alone or the repair with suture tape augmentation at all flexion angles. Repair with suture tape augmentation had significantly higher valgus angular stiffness compared with repair alone but not compared with intact.

      Conclusions

      Thumb UCL repair with suture tape augmentation is able to restore varus–valgus kinematics after complete UCL tear without over-constraining the joint. In addition, the higher angular stiffness afforded by the suture tape augmentation may allow for earlier rehabilitation after surgery.

      Clinical relevance

      Thumb UCL repair with suture tape augmentation may allow earlier return to sport in athletes than with repair alone.

      Key words

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