Ulnar collateral ligament reconstruction: The modified jobe technique

The anterior bundle of the ulnar collateral ligament (UCL) is the primary restraint to valgus forces at the elbow. 1 Injury to this structure can occur in individuals whose elbows are subjected to large valgus loads, as in throwing or as a result of elbow dislocation. Injury to the UCL is most commonly seen in overhead or throwing athletes whose elbows are subjected to repetitive valgus loads during the late cocking and early acceleration phases of throwing. Once injured, throwing athletes with UCL insufficiency often experience disabling elbow pain and are unable to compete at a high level. Jobe and colleagues provided the first description of surgical reconstruction of the UCL in 1986. 2 Since that time, this procedure has become the gold standard for surgical treatment of UCL deficiency. Several modifications have been made to the original technique to decrease the amount of soft tissue dissection required and lessen the technical demands of the operation. Reports have shown patients who have undergone this operation to return to their previous level of competition or a higher level more than 80% of the time. 3-5 This chapter describes the modified Jobe technique for UCL reconstruction, as well as discussing preoperative considerations and offering a brief review of reported results.