A UCL Repair is an outpatient procedure in which the surgeon makes a small incision over the medial aspect of the elbow. Appropriate dissection is performed to visualize the UCL and identify the pattern and location of the tear. If the injury pattern fits the criteria to proceed with the repair, the surgeon will repair the original ligament and reinforce it with a thick piece of suture called an “internal brace.” The internal brace has orthobiologic properties to aid in healing of the ligament.

1. When the patient has a certain pattern of injury to the UCL such as an avulsion type tear off of the upper arm bone (medial epicondyle) or forearm bone (sublime tubercle).
2. persistent medial elbow pain despite adequate rest
3. decreased performance or inability to perform in your sport
4. instability of the elbow
5. feeling “pop” sensation in the elbow at the time of injury

The initial phase of recovery is similar to that of the UCL reconstruction. During the first 2 weeks, the elbow is immobilized in a cast. After 2 weeks, the cast is removed, and the elbow is placed in a brace to protect the repair for another 6 weeks. Therapy is also initiated to improve range of motion and eventually strengthening will be introduced after 2 months.

1. A repair is performed with the internal brace. A reconstruction is performed with tendon graft from another part of the body.
2. The reconstruction requires 4 months of healing and graft incorporation prior to strengthening. After 8 weeks of therapy, a “rehab holiday” begins and therapy is put on hold until 4 months post op. The repair does not require a rehab holiday and the athlete may begin gradual strengthening at 2 months post op.
3. For the throwing athlete, the average recovery for a repair is 7-9 months. The average recovery for a reconstruction is 9-12 months.