Outcome measures after medial ulnar collateral ligament reconstructions in a military population

John B. Fuller*, John C. Dunn, Nicholas A. Kusnezov, Leon J. Nesti, Kelly G. Kilcoyne

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Background: Medial ulnar collateral ligament (MUCL) reconstruction outcomes are well described in competitive throwers but not in nonthrowers. This investigation elucidated epidemiologic variables, functional outcomes, and prognostic factors after MUCL reconstruction in young active patients. Methods: United States military service members undergoing MUCL reconstruction were isolated using the Management Analysis and Reporting Tool (M2) database from 2009 to 2016. Demographics, injury characteristics, and surgical variables were extracted. Multivariate analysis was performed, discerning variables predictive of postoperative functional outcomes, complications, and reoperation. Results: Sixty-six patients met inclusion criteria, and 47% participated in throwing sports. Of these, 36.4% reported a throwing mechanism of injury (MOI), 60.6% reported an acute trauma MOI, 59% reported preoperative ulnar nerve symptoms, and 39.4% experienced symptoms postoperatively. At final follow-up, average Disabilities of the Arm, Shoulder and Hand (DASH) and Mayo Elbow Performance Score (MEPS) scores were 10.8 ± 16.2 and 87.6 ± 17.1, respectively. A total of 86.4% reported no disability (DASH < 30), and 83.3% experienced good or excellent outcomes (MEPS >74). Age < 30 years, dominant arm injury, competitive throwing history, and throwing MOI correlated with improved DASH and MEPS scores, push-up count, postoperative pain and instability, and rates of ulnar nerve symptoms (P <.05). Psychiatric diagnosis and preoperative stiffness and instability were associated with lower outcome scores (P <.05). Ulnar nerve interventions did not correlate with presence or absence of postoperative ulnar nerve symptoms. Conclusions: MUCL reconstruction demonstrates a high good-to-excellent outcome rate and low complication and revision rates in young active individuals with intense upper extremity demands. Nonthrowing MOIs and psychiatric pathology are associated with postoperative complications and poorer outcomes.

Original languageEnglish
Pages (from-to)317-323
Number of pages7
JournalJournal of Shoulder and Elbow Surgery
Issue number2
StatePublished - Feb 2019
Externally publishedYes


  • Case Series
  • Level IV
  • Medial ulnar collateral ligament
  • Treatment Study
  • athlete
  • functional outcome
  • military
  • reconstruction
  • young active


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