Surgical Treatment of Posterolateral Rotatory Instability of the Elbow

Purpose: The purpose of this systematic review was to critically examine the outcomes of lateral ulnar collateral ligament reconstruction for posterolateral rotatory instability (PLRI) of the elbow.

Methods: A systematic review of the literature was performed. Two reviewers assessed and confirmed the methodologic and patient data from the included studies. Frequency-weighted means were calculated for outcomes that were present in multiple studies.

Results: Eight studies fulfilled our criteria, and they included 130 patients. The mean age was 38.1 years, and the mean follow-up period was 44.5 months. Traumatic dislocation was the most common cause of PLRI. Of the studies that reported the Mayo Elbow Performance Score, 91% of patients had good or excellent results, with a frequency-weighted mean of 91. Improvement in elbow range of motion was noted (133° to 138° of flexion [P < .0001] and 6.6° to 3.9° of extension [P = .005]). A complication rate of 11% was noted, with recurrent instability noted to occur in 8% of patients.

Conclusions: PLRI of the elbow remains to be fully understood. Treatment strategies vary and should be performed based on surgeon experience and evidence available. Most patients will have good or excellent results after surgery; however, up to 11% of patients may have complications.

Level Of Evidence: Level IV, systematic review of Level II through IV studies.