1. Figure 1 – Intraoperative Photo
Return to Play in High Level Athletes After Thumb UCL Repair with Suture Tape Augmentation
Steven S. Shin MD 1, Carola F. van Eck MD PhD 1,2, Carlos Uquillas MD, 1
Daniel B. Gibbs, MD Anthony De Giacomo, MD Steven Shin, MD
Kerlan Jobe Orthopaedic Clinic, Los Angeles, CA, USA
Introduction
Results
Nine thumbs in 8 high level athletes were included in the study. The study group was comprised of 1 collegiate baseball player, 4 professional baseball players, 2 professional basketball players and 1 high level high school basketball player.
Of the 9 thumb injuries in 8 athletes, 100% returned to play at the same level. No complications were reported.
Athletes who sustained an in season injury returned to play at any level at 30 days (SD +/-8.23) and at the same level at 32.1 (SD +/- 9.84).
Average return to play for the 2 athletes who sustained their injury and underwent surgery in the offseason was 182 days to any level and 200 days to the same level of play with both athletes participating at the soonest possible time for their respective sports
Thumb ulnar collateral ligament (UCL) tears occur commonly in elite athletes.
Minimal literature exists on return to play in elite athletes after UCL repair
The InternalBraceTM is an anchored augmenting suture that has been used with success in a number of ligament repair techniques throughout the body
To date, no literature exists on the outcomes of suture tape augmentation for repair of the thumb UCL.
Objective
Hypothesis: Utilizing suture tape augmentation for the thumb UCL will allow for a safe and expedient return to play in high level athletes.
Table 1 - Demographics
Methods
After IRB approval, a retrospective chart review was completed to identify all patients who underwent operative thumb UCL repair between 2014 and 2017.
Inclusion criteria were acute complete tears of the thumb metacarpophalangeal joint ulnar collateral ligament, treated with primary repair with suture tape augmentation in high level high school, collegiate or professional athletes.
Exclusion criteria included recreational athletes, patients who underwent reconstruction (rather than repair) and those patients with insufficient follow up to establish their return to play.
Charts of patients identified from the retrospective review were further evaluated to determine patient- related and injury-related variables. Return to play was defined as return to game competition at any level.
Table 2 - Return to Play
Figure 1 – Intraoperative Photo
Discussion
A complete tear of the thumb UCL requiring repair in elite athletes often results in missed practices and games. Returning athletes to competition as quickly as possible while protecting the repaired ligament until it heals is the primary goal of surgeons who treat these athletes.
Expert opinion and existing case series on return to play after UCL repair offer a wide range of timeframes.
Anchored suture tape augmentation enhances stability and provides support. This increased stability and level of support expedites return to play in this group of high level athletes.
Augmenting the repair with anchored suture may prevent prolonged immobilization, minimize necessary external support, expedite thumb motion, improve postoperative recovery and quicken an athletes return to play.